Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02731 | Date 06/08/2019 |
| Token No | SM/18-19/5435 06/08/2019 | Serial | 014 |
| Patient Name | Master SANJIB SANTRA | Contact No | 8697500856 |
| Address | 33 BHAGIRATHI LANE | Age | 16 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||