Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03603 | Date 12/12/2019 |
| Token No | SM/19-20/8025 12/12/2019 | Serial | 013 |
| Patient Name | Master SUBHA DAS | Contact No | 8961755378 |
| Address | 7 DEY GHAT LANE | Age | 13 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||