Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01809 | Date 19/03/2019 |
| Token No | SM/18-19/2881 19/03/2019 | Serial | 015 |
| Patient Name | Mr. RAJNISH KR PRASAD | Contact No | 8479971460 |
| Address | 9 RAM SITA LANE | Age | 15 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||