Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00606 | Date 23/12/2019 |
| Token No | SM/19-20/1306 30/12/2019 | Serial | 009 |
| Patient Name | Mr. LALTU MONDAL | Contact No | |
| Address | PRABASHNAGAR | Age | 17 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||