Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00998 | Date 18/02/2020 |
| Token No | SM/19-20/2372 18/02/2020 | Serial | 008 |
| Patient Name | Mrs. BULA PAL | Contact No | 8334972931 |
| Address | BIBIRBER GHORAMARA MALLICKPARA 712203 | Age | 35 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||