Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02651 | Date 29/07/2019 |
| Token No | SM/18-19/5231 29/07/2019 | Serial | 041 |
| Patient Name | Master AMIT KUMAR | Contact No | |
| Address | 55NO PANCHU BAZAR ROY LANE ROAD | Age | 1 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||