Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03558 | Date 06/12/2019 |
| Token No | SM/19-20/8009 10/12/2019 | Serial | 028 |
| Patient Name | Mr. ROHIT PRADHAN | Contact No | 9291528143 |
| Address | 7 NO LINE, INDIA JUTE MILL | Age | 10 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||