Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03980 | Date 06/07/2020 |
| Token No | SM/19-20/8795 06/07/2020 | Serial | 010 |
| Patient Name | Mrs. SALONI ROY | Contact No | 9163018342 |
| Address | 8 J N LAHIRI ROAD, BAT TALA | Age | 19 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||