Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01792 | Date 13/03/2019 |
| Token No | SM/18-19/6212 04/09/2019 | Serial | 014 |
| Patient Name | Master ANSH PRASAD | Contact No | 7003608069 |
| Address | 3 NO DEY GHAT LANE | Age | 4 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||