Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02110 | Date 24/05/2019 |
| Token No | SM/19-20/8091 16/12/2019 | Serial | 022 |
| Patient Name | Master SAJAN RAM | Contact No | 8910360960 |
| Address | 7 DEY GHAT LANE | Age | 8 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||