Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03363 | Date 14/11/2019 |
| Token No | SM/19-20/8189 02/01/2020 | Serial | 008 |
| 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 | 5 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||