Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03241 | Date 21/10/2019 |
| Token No | SM/18-19/7051 21/10/2019 | Serial | 018 |
| Patient Name | Baby SANA PALIT | Contact No | 8017502432 |
| Address | 14 DEY STREET | Age | 10 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||