Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 03993 | Date 12/08/2020 |
| Token No | SM/19-20/8822 12/08/2020 | Serial | 004 |
| Patient Name | Mrs. DURGA NANDI | Contact No | 9163667046 |
| Address | 128/A N N COLONY | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||