Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03363 | Date 14/11/2019 |
| Token No | SM/18-19/7366 14/11/2019 | Serial | 014 |
| Patient Name | Baby RIYAN GOSWAMI | Contact No | 8697390899 |
| Address | 107/A THAKUR BATI STREET | Age | 4 YRS 6 MNTHS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||