Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00665 | Date 04/01/2020 |
| Token No | SM/19-20/1398 04/01/2020 | Serial | 020 |
| Patient Name | Mrs. HARANI DHARA | Contact No | |
| Address | FOTKE KALITALA BORA | Age | 53 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||