Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02399 | Date 02/07/2019 |
| Token No | SM/18-19/4583 02/07/2019 | Serial | 013 |
| Patient Name | Miss PRIYA KUMARI | Contact No | NOT GIVEN |
| Address | 80A DEY STREET | Age | 7 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||