Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00102 | Date 13/09/2019 |
| Token No | SM/19-20/226 17/09/2019 | Serial | 035 |
| Patient Name | Miss AFRINA KHATUN | Contact No | 7602445932 |
| Address | 7 NO TARAPUKUR LANE MALLICKPARA 712203 | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||