Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02407 | Date 05/07/2019 |
| Token No | SM/18-19/7377 14/11/2019 | Serial | 025 |
| Patient Name | Mr. ARUN KUMAR SHA | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 14 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||