Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02807 | Date 16/08/2019 |
| Token No | SM/19-20/8919 24/09/2020 | Serial | 012 |
| Patient Name | Mrs. RUBI DEBI | Contact No | 9038101860 |
| Address | 6 RAM SITA LANE | Age | 28 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||