Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02414 | Date 05/07/2019 |
| Token No | SM/18-19/4611 05/07/2019 | Serial | 019 |
| Patient Name | Miss SOUMILI DEY | Contact No | 9330012728 |
| Address | 75 DEY STREET | Age | 6 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||