Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03226 | Date 18/10/2019 |
| Token No | SM/18-19/7003 18/10/2019 | Serial | 028 |
| Patient Name | Master RISHAV JAISWARA | Contact No | 9875650744 |
| Address | 7 DEY GHAT LANE | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||