Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 00268 | Date 11/08/2018 |
| Token No | SM/19-20/8459 24/01/2020 | Serial | 001 |
| Patient Name | Mrs. CHANDRABATI DEBI | Contact No | 9875693240 |
| Address | R,B SARANI | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||