Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03605 | Date 13/12/2019 |
| Token No | SM/19-20/8030 13/12/2019 | Serial | 003 |
| Patient Name | Miss SOHINI DAS | Contact No | 7278830385 |
| Address | 5 akhra bati lane | Age | 3 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||