Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02507 | Date 19/07/2019 |
| Token No | SM/18-19/5254 30/07/2019 | Serial | 019 |
| Patient Name | Miss TANU BISWAL | Contact No | 8100218312 |
| Address | N L BHATTACHARJEE STREET | Age | 7 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||