Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02941 | Date 30/08/2019 |
| Token No | SM/18-19/7273 05/11/2019 | Serial | 025 |
| Patient Name | Miss SARASWATI DAS | Contact No | 9330982165 |
| Address | PAL BAGAN | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||