Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03569 | Date 06/12/2019 |
| Token No | SM/19-20/7911 06/12/2019 | Serial | 025 |
| Patient Name | Mrs. SUNITA DEBI | Contact No | 9163765061 |
| Address | 7 DEY GHAT LANE | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||