Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02927 | Date 29/08/2019 |
| Token No | SM/18-19/6015 29/08/2019 | Serial | 013 |
| Patient Name | Miss PRERNA APAT | Contact No | 8910511528 |
| Address | 44B/5 N L BHATTACHARJEE ST | Age | 12 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||