Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02130 | Date 28/05/2019 |
| Token No | SM/21-22/20 05/04/2021 | Serial | 009 |
| Patient Name | Master ANKIT BHARTI | Contact No | NOT GIVEN |
| Address | 79 DEY ST | Age | 11 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||