Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02887 | Date 26/08/2019 |
| Token No | SM/18-19/5880 26/08/2019 | Serial | 008 |
| Patient Name | Miss SHILPA MUKHERJEE | Contact No | 9038508642 |
| Address | 30/31 PANCHANAN TALA LANE | Age | 15 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||