Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02391 | Date 01/07/2019 |
| Token No | SM/18-19/4565 01/07/2019 | Serial | 028 |
| Patient Name | Master YUVRAJ BISWAL | Contact No | 8444872666 |
| Address | PAL BAGAN DEY STREET | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||