Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00593 | Date 21/12/2019 |
| Token No | SM/19-20/1221 21/12/2019 | Serial | 010 |
| Patient Name | Mrs. LILI HARI | Contact No | 7603100116 |
| Address | NEW MAHESH SERAMPORE | Age | 15 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||