Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01828 | Date 28/03/2019 |
| Token No | SM/18-19/2928 28/03/2019 | Serial | 008 |
| Patient Name | Miss ISHITA SARKAR | Contact No | 8017789968 |
| Address | 3/2 K.C. MUKHERJEE STREET | Age | 13 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||