Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03721 | Date 08/01/2020 |
| Token No | SM/19-20/8316 08/01/2020 | Serial | 011 |
| Patient Name | Miss PRIYANKA SHA | Contact No | 8964859720 |
| Address | 45 K C BHATTACHARJEE STREET | Age | 19 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||