Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 03630 | Date 16/12/2019 |
| Token No | SM/19-20/8197 02/01/2020 | Serial | 016 |
| Patient Name | Mrs. RITA DEBI | Contact No | 7596969397 |
| Address | 18 JHAUTALA | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||