Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02475 | Date 15/07/2019 |
| Token No | SM/18-19/4877 19/07/2019 | Serial | 012 |
| Patient Name | Baby SANCHITA DAS | Contact No | NOT GIVEN |
| Address | 79 DEY STREET | Age | 3 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||