Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03628 | Date 16/12/2019 |
| Token No | SM/19-20/8107 16/12/2019 | Serial | 038 |
| Patient Name | Master RUDRA MAHAPATRA | Contact No | 9830599085 |
| Address | THAKUR BATI STREET | Age | 2 Y 6 M Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||