Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03002 | Date 06/09/2019 |
| Token No | SM/18-19/6765 27/09/2019 | Serial | 039 |
| Patient Name | Mr. SACHIN BISWAL | Contact No | 8697088466 |
| Address | 10 K D B LANE, DOSTI LANE | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||