Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04307 | Date 20/04/2021 |
| Token No | SM/21-22/126 20/04/2021 | Serial | 020 |
| Patient Name | Miss ANWESHA MUKHERJEE | Contact No | NOT GIVEN |
| Address | 101 N N COLONY | Age | 12 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||