Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01095 | Date 06/10/2018 |
| Token No | SM/18-19/2569 22/02/2019 | Serial | 012 |
| Patient Name | Miss PRIYA YADAV | Contact No | 9836051566 |
| Address | 11 DOSTI LANE | Age | 7 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||