Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00714 | Date 10/01/2020 |
| Token No | SM/19-20/1518 10/01/2020 | Serial | 012 |
| Patient Name | Miss ANEWSHA DUTTA | Contact No | 7596955737 |
| Address | 65/7/12 PRABASHNAGAR CHAKLAPARA 712249 | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||