Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02764 | Date 07/08/2019 |
| Token No | SM/18-19/5509 07/08/2019 | Serial | 025 |
| Patient Name | Mr. BHASKAR SHAW | Contact No | 8777822648 |
| Address | 19 DOSTI LANE | Age | 25 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||