Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02921 | Date 28/08/2019 |
| Token No | SM/18-19/5985 28/08/2019 | Serial | 005 |
| Patient Name | Master GANESH SHAW | Contact No | 9330783031 |
| Address | 55 RAYLAND ROAD | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||