Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01318 | Date 31/03/2020 |
| Token No | SM/19-20/3545 31/03/2020 | Serial | 010 |
| Patient Name | Master PRINCE SHAW | Contact No | |
| Address | PROVASNAGER | Age | 2Y3M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||