Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01086 | Date 27/02/2020 |
| Token No | SM/19-20/2627 27/02/2020 | Serial | 002 |
| Patient Name | Mrs. SUMI PAL | Contact No | 9143899995 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 17 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||