Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02896 | Date 26/08/2019 |
| Token No | SM/18-19/5917 26/08/2019 | Serial | 045 |
| Patient Name | Mr. HARE RAM PANDIT | Contact No | NOT GIVEN |
| Address | 162S DEY BAGAN | Age | 14 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||