Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 02848 | Date 20/08/2019 |
| Token No | SM/18-19/5743 20/08/2019 | Serial | 011 |
| Patient Name | Master BIKRAM PATWA | Contact No | 9038696522 |
| Address | 30 K M BHATTACHARYA STREET | Age | 4 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||