Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00546 | Date 13/12/2019 |
| Token No | SM/19-20/1078 13/12/2019 | Serial | 004 |
| Patient Name | Mrs. ANIMA DEY | Contact No | |
| Address | CHAKLAPARA PRABASHNAGAR | Age | 63 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||