Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 01632 | Date 08/02/2019 |
| Token No | SM/18-19/2386 08/02/2019 | Serial | 001 |
| Patient Name | Master ADITYA DEY | Contact No | 7044629112 |
| Address | 45/1 JITEN LAHIRI ROAD | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||