Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03375 | Date 14/11/2019 |
| Token No | SM/18-19/7393 14/11/2019 | Serial | 041 |
| Patient Name | Miss RIYA BISWAL | Contact No | 6291877649 |
| Address | 14B DEY STREET | Age | 7 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||