Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02669 | Date 31/07/2019 |
| Token No | SM/18-19/5294 31/07/2019 | Serial | 002 |
| Patient Name | Miss SAYANTIKA MALIK | Contact No | 7980128858 |
| Address | CHOWDHURY PARA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||