Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00674 | Date 06/01/2020 |
| Token No | SM/19-20/1589 15/01/2020 | Serial | 002 |
| Patient Name | Mrs. DHARAMSHILA DEBI | Contact No | 8232891706 |
| Address | CHAKLAPARA PRABASNAGAR | Age | 30 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||