Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03595 | Date 10/12/2019 |
| Token No | SM/19-20/7991 10/12/2019 | Serial | 010 |
| Patient Name | Mrs. BHARATI BISWAL | Contact No | 8100218312 |
| Address | 45 DR. N L BHATTACHARYA STREET | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||