Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03669 | Date 03/01/2020 |
| Token No | SM/19-20/8222 03/01/2020 | Serial | 020 |
| Patient Name | Mr. BHOLA CHANDA | Contact No | 9903531379 |
| Address | DHARMATALA | Age | 4 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||