Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00963 | Date 25/09/2018 |
| Token No | SM/18-19/1247 25/09/2018 | Serial | 009 |
| Patient Name | Mr. PAWAN KUMAR | Contact No | 8697588461 |
| Address | 3 DEY GHAT LANE | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||