Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03537 | Date 03/12/2019 |
| Token No | SM/19-20/7842 03/12/2019 | Serial | 010 |
| Patient Name | Miss PUJA KUMARI | Contact No | 9163363547 |
| Address | 9 BECHU DEY LANE | Age | 18 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||