Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02068 | Date 16/05/2019 |
| Token No | SM/18-19/3676 16/05/2019 | Serial | 016 |
| Patient Name | Baby KHUSHI KUMARI | Contact No | 8199931294 |
| Address | 6 RAMSITA LANE, NAYA BAGAN | Age | 5 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||