Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00253 | Date 25/09/2019 |
| Token No | SM/19-20/341 25/09/2019 | Serial | 017 |
| Patient Name | Mr. BIKAS RASOWA | Contact No | |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 16 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||