Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01798 | Date 13/03/2019 |
| Token No | SM/18-19/2827 13/03/2019 | Serial | 017 |
| Patient Name | Mrs. MIRA MANJHI | Contact No | NOT GIVEN |
| Address | AKHRA BATI LANE | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||