Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01342 | Date 06/12/2018 |
| Token No | SM/18-19/1892 06/12/2018 | Serial | 011 |
| Patient Name | Master ROBI ROY | Contact No | 8335862752 |
| Address | 3 DEY GHAT LANE | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||