Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03708 | Date 07/01/2020 |
| Token No | SM/19-20/8297 07/01/2020 | Serial | 028 |
| Patient Name | Mrs. APARNA DAS | Contact No | 9163593309 |
| Address | 5/A BHAGIRATHI LANE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||