Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03656 | Date 02/01/2020 |
| Token No | SM/19-20/8195 02/01/2020 | Serial | 014 |
| Patient Name | Mrs. KALYANI PATRA | Contact No | 9038626235 |
| Address | 50 SASHI BHUSAN GHOSH LANE | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||