Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03578 | Date 09/12/2019 |
| Token No | SM/19-20/7938 09/12/2019 | Serial | 011 |
| Patient Name | Master PRINCE KUMAR THAKUR | Contact No | NOT GIVEN |
| Address | 2 MLAL BAHADUR SASTRI ROAD, TINBAZAR | Age | 10 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||