Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03302 | Date 31/10/2019 |
| Token No | SM/18-19/7189 31/10/2019 | Serial | 006 |
| Patient Name | Miss ARPITA KUMARI PATWA | Contact No | 9038696522 |
| Address | 12 K M BHATTACHARYA | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||