Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02147 | Date 30/05/2019 |
| Token No | SM/19-20/8528 28/01/2020 | Serial | 028 |
| Patient Name | Mrs. NITU DEVI | Contact No | 9662217466 |
| Address | DEY ST PALBAGAN | Age | 26 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||