Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02128 | Date 28/05/2019 |
| Token No | SM/18-19/6689 25/09/2019 | Serial | 007 |
| Patient Name | Mr. AZAD KHAN | Contact No | 9681443236 |
| Address | 84 DEY ST | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||