Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02985 | Date 04/09/2019 |
| Token No | SM/18-19/6217 04/09/2019 | Serial | 019 |
| Patient Name | Master ROMIT MUKHERJEE | Contact No | 9433326416 |
| Address | 151 THAKUR BATI STREET | Age | 13 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||