Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01740 | Date 01/03/2019 |
| Token No | SM/18-19/2656 01/03/2019 | Serial | 015 |
| Patient Name | Miss ANWESHA MUKHERJEE | Contact No | 9804872696 |
| Address | 101/A NEHERU NAGAR COLONY | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||