Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03166 | Date 09/10/2019 |
| Token No | SM/18-19/6857 09/10/2019 | Serial | 004 |
| Patient Name | Master ROHIT HELA | Contact No | 9830908114 |
| Address | PANCHANAN TALA LANE | Age | 4 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||