Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03720 | Date 08/01/2020 |
| Token No | SM/19-20/8315 08/01/2020 | Serial | 010 |
| Patient Name | Mr. ADITYA JAISWARA | Contact No | 9674859644 |
| Address | 56 DEY STREET | Age | 18 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||