Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00598 | Date 23/12/2019 |
| Token No | SM/19-20/1229 23/12/2019 | Serial | 001 |
| Patient Name | Miss ANUSKA KUMARI | Contact No | 8240117477 |
| Address | SATGHARA PASCHIMPARA SERAMPORE 712203 | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||