Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03450 | Date 21/11/2019 |
| Token No | SM/18-19/7586 21/11/2019 | Serial | 007 |
| Patient Name | Baby SK OWAIS | Contact No | 8981443008 |
| Address | 18 A K C BHATTACHARYA STREET | Age | 2 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||