Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02695 | Date 02/08/2019 |
| Token No | SM/18-19/5347 02/08/2019 | Serial | 007 |
| Patient Name | Master SK KABIR ALI | Contact No | 7449643523 |
| Address | 21/A K C BHATTACHARYA STREET | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||