Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02735 | Date 06/08/2019 |
| Token No | SM/18-19/6001 28/08/2019 | Serial | 021 |
| Patient Name | Miss RAMA ROY | Contact No | 7890882262 |
| Address | TALPUKUR LOKENATH PALLY | Age | 17 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||