Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03937 | Date 18/03/2020 |
| Token No | SM/19-20/8726 18/03/2020 | Serial | 008 |
| Patient Name | Mrs. MOHORJAAN BEGUM | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||