Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 00234 | Date 24/09/2019 |
| Token No | SM/19-20/316 24/09/2019 | Serial | 025 |
| Patient Name | Miss BANDANA SHAW | Contact No | 8100469558 |
| Address | 9 S S ROAD RISHRA M HOOGHLY 712249 | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||