Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00600 | Date 23/12/2019 |
| Token No | SM/19-20/1232 23/12/2019 | Serial | 004 |
| Patient Name | Mrs. SARASWATI SINGH | Contact No | |
| Address | 12E MIYAJAN DARJEE LANE MALLICKPARA | Age | 70 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||