Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01690 | Date 19/02/2019 |
| Token No | SM/18-19/2819 13/03/2019 | Serial | 009 |
| Patient Name | Master ABHISHEK ROY | Contact No | NOT GIVEN |
| Address | 9 BECGHU DEY LANE | Age | 12 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||