Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02799 | Date 13/08/2019 |
| Token No | SM/18-19/6376 12/09/2019 | Serial | 023 |
| Patient Name | Mr. ANKIT ROY | Contact No | 8478004074 |
| Address | 56 AKHRA BATI LANE | Age | 12 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||