Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00616 | Date 27/12/2019 |
| Token No | SM/19-20/1271 27/12/2019 | Serial | 005 |
| Patient Name | Mrs. SUJATA DAS | Contact No | 7890489650 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||