Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01697 | Date 21/02/2019 |
| Token No | SM/18-19/2534 21/02/2019 | Serial | 002 |
| Patient Name | Master KARAN KUMAR MANJHI | Contact No | NOT GIVEN |
| Address | 18 NO LINE JUTE MILL | Age | 8 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||