Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02243 | Date 13/06/2019 |
| Token No | SM/18-19/4115 13/06/2019 | Serial | 005 |
| Patient Name | Baby JASHMIN KHATUN | Contact No | NOT GIVEN |
| Address | DANKUNI | Age | 7 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||