Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02705 | Date 02/08/2019 |
| Token No | SM/18-19/5367 02/08/2019 | Serial | 027 |
| Patient Name | Master SHIBAM KUMAR | Contact No | |
| Address | AKC BHATTACHARAYA DEY STREET | Age | 7 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||