Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03191 | Date 15/10/2019 |
| Token No | SM/18-19/6925 15/10/2019 | Serial | 017 |
| Patient Name | Miss NEHA RAM | Contact No | 6291626680 |
| Address | 2 GOPAL GANGULY LANE | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||