Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01734 | Date 28/02/2019 |
| Token No | SM/18-19/2641 28/02/2019 | Serial | 025 |
| Patient Name | Miss PRIYANKA SAMANTA | Contact No | |
| Address | TARAKESWAR | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||