Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02193 | Date 06/06/2019 |
| Token No | SM/18-19/4965 19/07/2019 | Serial | 006 |
| Patient Name | Master ANAND KUMAR | Contact No | NOT GIVEN |
| Address | NAYA BAGAN RAM SITA LANE | Age | 6 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||