Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03715 | Date 08/01/2020 |
| Token No | SM/19-20/8310 08/01/2020 | Serial | 005 |
| Patient Name | Mrs. NIVA DEBI | Contact No | 7980013630 |
| Address | DEY BARI | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||