Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 01739 | Date 01/03/2019 |
| Token No | SM/18-19/2653 01/03/2019 | Serial | 012 |
| Patient Name | Baby KEYA SURAI | Contact No | 8820616154 |
| Address | 15 RAILAND ROAD | Age | 5 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||