Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02130 | Date 28/05/2019 |
| Token No | SM/18-19/4899 19/07/2019 | Serial | 034 |
| Patient Name | Master ANKIT BHARTI | Contact No | NOT GIVEN |
| Address | 79 DEY ST | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||