Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02839 | Date 19/08/2019 |
| Token No | SM/18-19/5726 19/08/2019 | Serial | 034 |
| Patient Name | Master PRITAM KUMAR | Contact No | NOT GIVEN |
| Address | R B SARANI | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||