Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03999 | Date 13/08/2020 |
| Token No | SM/19-20/8828 13/08/2020 | Serial | 003 |
| Patient Name | Master RAJESH RAJBHAR | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 8 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||