Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02095 | Date 21/05/2019 |
| Token No | SM/18-19/3749 21/05/2019 | Serial | 002 |
| Patient Name | Miss BABY KUMARI | Contact No | 6290395529 |
| Address | 7 DEY GHAT LANE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||