Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02325 | Date 20/06/2019 |
| Token No | SM/18-19/4330 20/06/2019 | Serial | 016 |
| Patient Name | Master SIBAPRASAD SHAW | Contact No | 9836365285 |
| Address | 82 DEY ST | Age | 9 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||