Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00213 | Date 23/08/2018 |
| Token No | SM/18-19/229 23/08/2018 | Serial | 003 |
| Patient Name | Master ARYAN PRADHAN | Contact No | |
| Address | COCKRAIN ROAD | Age | 8 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||