Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01620 | Date 05/02/2019 |
| Token No | SM/18-19/2356 05/02/2019 | Serial | 016 |
| Patient Name | Mr. BIKASH KUMAR | Contact No | NOT GIVEN |
| Address | 10 DEY ST | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||