Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02030 | Date 03/05/2019 |
| Token No | SM/18-19/3540 03/05/2019 | Serial | 018 |
| Patient Name | Baby HENA BHUIYA | Contact No | NOT GIVEN |
| Address | J.N.LAHIRI ROAD | Age | 4 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||