Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03506 | Date 29/11/2019 |
| Token No | SM/19-20/8085 16/12/2019 | Serial | 016 |
| Patient Name | Miss TIYASHA SETH | Contact No | 9433066725 |
| Address | 10/C CHATTERJEE LANE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||