Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01368 | Date 14/12/2018 |
| Token No | SM/18-19/3223 12/04/2019 | Serial | 016 |
| Patient Name | Master HIMANSU PRASAD | Contact No | 9883670314 |
| Address | 3 DEY GHAT LANE | Age | 6 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||