Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03622 | Date 16/12/2019 |
| Token No | SM/19-20/8098 16/12/2019 | Serial | 029 |
| Patient Name | Mrs. BHARATI BISWAL | Contact No | 9123709043 |
| Address | 44/A/1/A 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 | |||