Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02867 | Date 21/08/2019 |
| Token No | SM/18-19/5817 21/08/2019 | Serial | 034 |
| Patient Name | Master SK. SARFARAJ | Contact No | 9330828510 |
| Address | 9 NO KC BHATTACHARJEE LANE | Age | 9 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||