Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02199 | Date 06/06/2019 |
| Token No | SM/18-19/3996 06/06/2019 | Serial | 021 |
| Patient Name | Mr. RAJ SHAW | Contact No | 9836078533 |
| Address | PACHU BABUIR BAZAR | Age | 16 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||