Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01047 | Date 05/10/2018 |
| Token No | SM/18-19/1367 05/10/2018 | Serial | 008 |
| Patient Name | Miss MOHINI BISWAL | Contact No | 9874292729 |
| Address | INDIA JUTE MILL 8/434 | Age | 8 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||