Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00340 | Date 05/11/2019 |
| Token No | SM/19-20/610 08/11/2019 | Serial | 010 |
| Patient Name | Mrs. PAYEL DAS | Contact No | 8296454513 |
| Address | SUKANTA PALLY PRABASHNAGAR | Age | 18 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||