Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00948 | Date 24/09/2018 |
| Token No | SM/18-19/1229 24/09/2018 | Serial | 008 |
| Patient Name | Miss SANCHARI DAS | Contact No | 9674363688 |
| Address | CHATRA SEARAMPORE | Age | 12 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||