Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01246 | Date 20/03/2020 |
| Token No | SM/19-20/3311 20/03/2020 | Serial | 029 |
| Patient Name | Mr. AMON SINGH | Contact No | |
| Address | PROVASNAGER | Age | 17 Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||