Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04028 | Date 21/09/2020 |
| Token No | SM/19-20/8884 21/09/2020 | Serial | 004 |
| Patient Name | Master KRISHNA KUMAR | Contact No | 7439008931 |
| Address | DEY STREET | Age | 10 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||