Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00614 | Date 26/12/2019 |
| Token No | SM/19-20/1266 26/12/2019 | Serial | 006 |
| Patient Name | Master RAHUL MISTRI | Contact No | |
| Address | BAGERBAGAN LANE,SERAMPORE | Age | 6 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||