Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01699 | Date 21/02/2019 |
| Token No | SM/18-19/2536 21/02/2019 | Serial | 004 |
| Patient Name | Miss NEHA GIRI | Contact No | 6290161239 |
| Address | 17/C N L BHATTACHARJEE STREET | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||