Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01876 | Date 04/04/2019 |
| Token No | SM/18-19/3073 04/04/2019 | Serial | 048 |
| Patient Name | Miss SANCHITA SAHA | Contact No | |
| Address | Age | 12 Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||