Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01840 | Date 29/03/2019 |
| Token No | SM/18-19/2966 29/03/2019 | Serial | 014 |
| Patient Name | Mr. SK SAI | Contact No | 7044760767 |
| Address | 15 K.C BHATTACHARYA ST | Age | 14 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||