Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02479 | Date 15/07/2019 |
| Token No | SM/18-19/4784 15/07/2019 | Serial | 030 |
| Patient Name | Mr. SUJAL VERMA | Contact No | 8013388216 |
| Address | DEY STREET | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||