Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03057 | Date 16/09/2019 |
| Token No | SM/19-20/7858 05/12/2019 | Serial | 008 |
| Patient Name | Miss AROHI KUMARI | Contact No | NOT GIVEN |
| Address | 12 PITAMBAR DEY LANE | Age | 2 Y 6 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||