Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03257 | Date 22/10/2019 |
| Token No | SM/19-20/7957 09/12/2019 | Serial | 030 |
| Patient Name | Miss DISHA GHOSH | Contact No | 8697361168 |
| Address | 12 DHARMATALA | Age | 16 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||