Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 04046 | Date 24/09/2020 |
| Token No | SM/19-20/8921 24/09/2020 | Serial | 014 |
| Patient Name | Master BABUSAN NAYEK | Contact No | NOT GIVEN |
| Address | JITEN LAHIRI ROAD | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||