Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04053 | Date 25/09/2020 |
| Token No | SM/19-20/8950 25/09/2020 | Serial | 012 |
| Patient Name | Miss NEHA KUMARI.. | Contact No | 9062375128 |
| Address | 30 NANILAL BHATTACHARJEE STREET | Age | 21 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||