Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01607 | Date 01/02/2019 |
| Token No | SM/18-19/2332 01/02/2019 | Serial | 004 |
| Patient Name | Miss ANJALI SHAW | Contact No | 6291235475 |
| Address | 67 AKHRA BATI LANE | Age | 15 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||