Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00982 | Date 27/09/2018 |
| Token No | SM/18-19/1274 27/09/2018 | Serial | 014 |
| Patient Name | Master SUMIT KHATIK | Contact No | 882034468 |
| Address | DEY STREET | Age | 13 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||