Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00637 | Date 31/12/2019 |
| Token No | SM/19-20/1337 31/12/2019 | Serial | 020 |
| Patient Name | Mrs. SUSHMA MALICK | Contact No | 8487818805 |
| Address | CHAKLAPARA PRABASNAGAR | Age | 29 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||