Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03451 | Date 21/11/2019 |
| Token No | SM/18-19/7603 21/11/2019 | Serial | 024 |
| Patient Name | Master G.YASHWIN | Contact No | NOT GIVEN |
| Address | SERAMPORE 58 NO LANE | Age | 8 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||