Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00652 | Date 04/09/2018 |
| Token No | SM/18-19/2344 05/02/2019 | Serial | 004 |
| Patient Name | Master AMIT KR BISWAL | Contact No | 9836010315 |
| Address | INDIAN JUTE MILL | Age | 10 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||