Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 03303 | Date 31/10/2019 |
| Token No | SM/18-19/7416 15/11/2019 | Serial | 015 |
| Patient Name | Miss ANWESHA MUKHERJEE | Contact No | 9836617040 |
| Address | 101/A N N COLONY | Age | 15 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||