Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02898 | Date 26/08/2019 |
| Token No | SM/18-19/5919 26/08/2019 | Serial | 047 |
| Patient Name | Master MAYUK SARKAR | Contact No | |
| Address | 11B/1 RAM SITA LANE | Age | 7 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||