Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03673 | Date 03/01/2020 |
| Token No | SM/19-20/8231 03/01/2020 | Serial | 029 |
| Patient Name | Master SOURAV SHAW | Contact No | 9330287376 |
| Address | 2 LALIT MOHAN BHATTACHARYA STREET | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||