Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00578 | Date 19/12/2019 |
| Token No | SM/19-20/1178 19/12/2019 | Serial | 002 |
| Patient Name | Mr. NIKHIL ROY | Contact No | 8583047025 |
| Address | 5/ TARA PUKUR QUATER | Age | 12 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||