Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03609 | Date 13/12/2019 |
| Token No | SM/19-20/8040 13/12/2019 | Serial | 013 |
| Patient Name | Mrs. RAMA ROY | Contact No | 9681930196 |
| Address | AKHRA BATI | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||