Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03524 | Date 02/12/2019 |
| Token No | SM/19-20/7861 05/12/2019 | Serial | 011 |
| Patient Name | Master UMA SANKAR | Contact No | 6280339317 |
| Address | 44 B/2 N L BHATTACHARYA STREET | Age | 11 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||