Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00223 | Date 23/09/2019 |
| Token No | SM/19-20/1024 09/12/2019 | Serial | 005 |
| Patient Name | Master KESHAB SINGH | Contact No | 9230276045 |
| Address | 28/1 TARAPUKUR LANE SERAMPORE 712203 | Age | 6 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||