Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03482 | Date 26/11/2019 |
| Token No | SM/19-20/7684 26/11/2019 | Serial | 013 |
| Patient Name | Master SUVANKAR PADIARI | Contact No | NOT GIVEN |
| Address | 7 NO LINE | Age | 9 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||