Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03593 | Date 10/12/2019 |
| Token No | SM/19-20/7982 10/12/2019 | Serial | 001 |
| Patient Name | Baby MARYAM ARA | Contact No | 7003406226 |
| Address | 10 CHATTERJEE LANE | Age | 2 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||