Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00092 | Date 12/09/2019 |
| Token No | SM/19-20/98 12/09/2019 | Serial | 015 |
| Patient Name | Miss PRIYANKA DAS | Contact No | 6290521542 |
| Address | 65/22/1 PROVASNAGER SERAMPORE 712249 | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||