Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02687 | Date 01/08/2019 |
| Token No | SM/18-19/5331 01/08/2019 | Serial | 022 |
| Patient Name | Master ROHIT KUMAR | Contact No | 8961550020 |
| Address | 26NO K.C BHATTACHARYA STREET | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||