Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02769 | Date 08/08/2019 |
| Token No | SM/18-19/5523 08/08/2019 | Serial | 010 |
| Patient Name | Master SANDIP ROY | Contact No | 9062627142 |
| Address | AKHRA BATI LANE | Age | 11 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||