Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03324 | Date 01/11/2019 |
| Token No | SM/18-19/7241 01/11/2019 | Serial | 023 |
| Patient Name | Miss AVANTIKA BISWAL | Contact No | 9123709043 |
| Address | 45 DR N L BHATTACHARYA STREET | Age | 14 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||