Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01041 | Date 22/02/2020 |
| Token No | SM/19-20/2476 22/02/2020 | Serial | 014 |
| Patient Name | Master MOHON DAS | Contact No | |
| Address | PROVASNAGER | Age | 1YEAR 6 MONTH Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||