Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02899 | Date 27/08/2019 |
| Token No | SM/18-19/6299 06/09/2019 | Serial | 047 |
| Patient Name | Miss PUJA DEBNATH | Contact No | 9051922556 |
| Address | 39/A PATUA PARA LANE | Age | 16 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||