Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03580 | Date 09/12/2019 |
| Token No | SM/19-20/8074 16/12/2019 | Serial | 005 |
| Patient Name | Mrs. PRIYANKA DAS ROY | Contact No | 8240757160 |
| Address | 48 K M BHATTACHARYA STREET | Age | 27 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||