Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02878 | Date 22/08/2019 |
| Token No | SM/18-19/5846 22/08/2019 | Serial | 024 |
| Patient Name | Master AMIT KUMAR BISWAL | Contact No | 9836010315 |
| Address | INDIA JUTE MILL, 9 NO LINE | Age | 12 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||