Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00988 | Date 27/09/2018 |
| Token No | SM/18-19/1286 27/09/2018 | Serial | 026 |
| Patient Name | Mr. NIRAJ KR ROY | Contact No | 8013280906 |
| Address | RAM SITA LANE | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||