Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01600 | Date 22/01/2019 |
| Token No | SM/18-19/2318 22/01/2019 | Serial | 014 |
| Patient Name | Master RAHUL BISWAL | Contact No | 8100218312 |
| Address | N L BHATTACHARJEE | Age | 12 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||