Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01139 | Date 12/10/2018 |
| Token No | SM/18-19/2880 19/03/2019 | Serial | 014 |
| Patient Name | Mr. ASUTOSH KAIRI | Contact No | 8481042209 |
| Address | DEY STREET | Age | 11 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||