Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03521 | Date 02/12/2019 |
| Token No | SM/19-20/7910 06/12/2019 | Serial | 024 |
| Patient Name | Mrs. LIPIKA BISWAL | Contact No | 7278987710 |
| Address | 10 KALI DAS BHATTACHARYA LANE | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||