Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01678 | Date 15/02/2019 |
| Token No | SM/18-19/7006 18/10/2019 | Serial | 031 |
| Patient Name | Master RAJ PRASAD | Contact No | 7890275798 |
| Address | 79 DEY STREET | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||