Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01469 | Date 20/04/2020 |
| Token No | SM/19-20/3892 20/04/2020 | Serial | 023 |
| Patient Name | Mrs. JAMUNA SHAW | Contact No | 9123820272 |
| Address | PRABASHNAGAR POST OFFICE 712249 | Age | 15 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||