Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01224 | Date 30/10/2018 |
| Token No | SM/19-20/7748 29/11/2019 | Serial | 011 |
| Patient Name | Mrs. SUPRIYA DAS | Contact No | 9051756083 |
| Address | 36/37A R B SARANI | Age | 51 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||