Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01214 | Date 17/03/2020 |
| Token No | SM/19-20/3178 17/03/2020 | Serial | 026 |
| Patient Name | Mr. ADARSH KUMAR SINGH | Contact No | 9208866405 |
| Address | 13/39 SARADA PALLY SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||