Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00506 | Date 04/12/2019 |
| Token No | SM/19-20/1019 07/12/2019 | Serial | 011 |
| Patient Name | Mrs. KRISHNA DEBI | Contact No | |
| Address | 122 GURU GARDEN ROAD PRABASHNAGAR | Age | 55 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||