Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02377 | Date 28/06/2019 |
| Token No | SM/18-19/4524 28/06/2019 | Serial | 014 |
| Patient Name | Mr. SANDIP KUMAR JHA | Contact No | 8013280902 |
| Address | 5/2/C GOPAL GANGULY LANE | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||