Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01038 | Date 04/10/2018 |
| Token No | SM/18-19/1349 04/10/2018 | Serial | 008 |
| Patient Name | Mr. BIPIN CHAND | Contact No | 8423197161 |
| Address | 79 DEY STREET | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||