Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01661 | Date 14/02/2019 |
| Token No | SM/19-20/8810 14/07/2020 | Serial | 008 |
| Patient Name | Mrs. LALMONI DEBI | Contact No | 7890275798 |
| Address | 79 DEY STREET | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||