Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02841 | Date 19/08/2019 |
| Token No | SM/18-19/5990 28/08/2019 | Serial | 010 |
| Patient Name | Miss NANDINI ROY | Contact No | 8478004074 |
| Address | 66AKRA BATI LANE | Age | 16 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||