Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01317 | Date 29/11/2018 |
| Token No | SM/18-19/1844 29/11/2018 | Serial | 012 |
| Patient Name | Miss NEHA KUMARI | Contact No | 9062375128 |
| Address | 30 DR NANILAL BHATTACHARYA STREET | Age | 18 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||