Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03979 | Date 06/07/2020 |
| Token No | SM/19-20/8791 06/07/2020 | Serial | 006 |
| Patient Name | Mrs. RUMA DEBI | Contact No | NOT GIVEN |
| Address | 1/A RAYLAND ROAD | Age | 21 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||