Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01204 | Date 17/03/2020 |
| Token No | SM/19-20/3375 24/03/2020 | Serial | 006 |
| Patient Name | Mrs. SOUMITA MAJHI | Contact No | 8697353172 |
| Address | 6A HARIPARA LANE SERAMPORE 712203 | Age | 11 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||