Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00816 | Date 27/01/2020 |
| Token No | SM/19-20/2943 07/03/2020 | Serial | 041 |
| Patient Name | Mrs. DULALI CHANDRA | Contact No | 9143061287 |
| Address | GHORAMARA PURBAPARA 712203 | Age | 56 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||