Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02561 | Date 20/07/2019 |
| Token No | SM/18-19/5011 20/07/2019 | Serial | 021 |
| Patient Name | Miss ASTHA PATHAK | Contact No | 7003608069 |
| Address | MANIK TALA | Age | 6 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||