Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03688 | Date 06/01/2020 |
| Token No | SM/19-20/8373 13/01/2020 | Serial | 029 |
| Patient Name | Mrs. SOMARI DEBI | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||