Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03592 | Date 09/12/2019 |
| Token No | SM/19-20/7977 09/12/2019 | Serial | 050 |
| Patient Name | Master KARAN ROY | Contact No | NOT GIVEN |
| Address | 19/A K C BHATTACHARJEE STREET | Age | 9 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||