Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01448 | Date 20/12/2018 |
| Token No | SM/19-20/7693 26/11/2019 | Serial | 022 |
| Patient Name | Master SUMIT JENA | Contact No | 9038801477 |
| Address | SERAMPORE COLLEGE | Age | 14 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||