Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 03105 | Date 23/09/2019 |
| Token No | SM/18-19/6640 23/09/2019 | Serial | 042 |
| Patient Name | Miss SOMA MONDAL | Contact No | 9231558069 |
| Address | 407 GT ROAD | Age | 10 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||