Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00780 | Date 21/01/2020 |
| Token No | SM/19-20/1713 21/01/2020 | Serial | 025 |
| Patient Name | Mrs. RAMTIARI SHAW | Contact No | |
| Address | PROVASNAGER | Age | 50 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||