Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01351 | Date 11/12/2018 |
| Token No | SM/18-19/1917 11/12/2018 | Serial | 005 |
| Patient Name | Master SEKH ARIYAN | Contact No | 8334072423 |
| Address | K.C BHATTACHARYA ST. | Age | 7 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||