Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03015 | Date 09/09/2019 |
| Token No | SM/18-19/6314 09/09/2019 | Serial | 010 |
| Patient Name | Miss AROHI KUMARI DAS | Contact No | 9875497730 |
| Address | 12 PITAMBAR DEY LANE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||