Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02970 | Date 02/09/2019 |
| Token No | SM/18-19/6147 02/09/2019 | Serial | 005 |
| Patient Name | Master GYANCHAR RAY | Contact No | 9330598093 |
| Address | INDIA JUTE MILL RAM SITA LANE | Age | 17 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||