Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02723 | Date 05/08/2019 |
| Token No | SM/18-19/5415 05/08/2019 | Serial | 019 |
| Patient Name | Miss POULAMI DEY | Contact No | 9477502081 |
| Address | 5/E GOPAL GANGULY | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||