Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03475 | Date 22/11/2019 |
| Token No | SM/18-19/7670 22/11/2019 | Serial | 029 |
| Patient Name | Mr. AMAN BARIK | Contact No | 8777631750 |
| Address | 45 N L BHATTACHARYA STREET | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||