Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04015 | Date 25/08/2020 |
| Token No | SM/19-20/8855 25/08/2020 | Serial | 004 |
| Patient Name | Mrs. DIPALI SAHA | Contact No | 8697632909 |
| Address | MAHESH NEHEREU NAGAR COLONY | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||