Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01637 | Date 08/02/2019 |
| Token No | SM/18-19/4120 13/06/2019 | Serial | 010 |
| Patient Name | Mr. ARUN SHA | Contact No | NOT GIVEN |
| Address | 3 DEY GHAT LANE | Age | 14 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||