Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01307 | Date 27/11/2018 |
| Token No | SM/18-19/1829 27/11/2018 | Serial | 017 |
| Patient Name | Master SUJAN SRIMANI | Contact No | 9874698729 |
| Address | 61 DEY STREET | Age | 3 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||