Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03556 | Date 05/12/2019 |
| Token No | SM/19-20/7886 05/12/2019 | Serial | 036 |
| Patient Name | Miss SIBANI DAS | Contact No | 6291982851 |
| Address | 79 DEY ST | Age | 16 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||