Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03138 | Date 27/09/2019 |
| Token No | SM/18-19/6775 27/09/2019 | Serial | 049 |
| Patient Name | Miss POSHALI KURMI | Contact No | NOT GIVEN |
| Address | 4D DEY ST | Age | 7 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||