Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01952 | Date 22/04/2019 |
| Token No | SM/18-19/3318 22/04/2019 | Serial | 011 |
| Patient Name | Master DEBRAJ BISWAL | Contact No | 8100218321 |
| Address | N L BHATTACHARJEE STREET | Age | 12 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||