Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03030 | Date 12/09/2019 |
| Token No | SM/18-19/6373 12/09/2019 | Serial | 020 |
| Patient Name | Master HRITTIK ROY | Contact No | 8478004074 |
| Address | 56 AKHRA BATI | Age | 5 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||