Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00270 | Date 30/09/2019 |
| Token No | SM/19-20/379 30/09/2019 | Serial | 003 |
| Patient Name | Mrs. RINA NAYEK | Contact No | 9681360388 |
| Address | MINIUS QUARTER.PRABASHNAGAR | Age | 24 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||