Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02704 | Date 02/08/2019 |
| Token No | SM/18-19/5366 02/08/2019 | Serial | 026 |
| Patient Name | Master RAJ KUMAR | Contact No | 7463963488 |
| Address | AKC BHATTACHARYA DEY STREET | Age | 6 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||