Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03525 | Date 02/12/2019 |
| Token No | SM/19-20/7803 02/12/2019 | Serial | 008 |
| Patient Name | Mrs. KANCHAN PRADHAN | Contact No | NOT GIVEN |
| Address | RAM SITA LANE | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||