Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01685 | Date 19/02/2019 |
| Token No | SM/18-19/2540 21/02/2019 | Serial | 008 |
| Patient Name | Master SK.SAYEET | Contact No | 9748144788 |
| Address | 13 K.C BHATTACHARYA LANE | Age | 7 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||