Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01943 | Date 22/04/2019 |
| Token No | SM/18-19/3297 22/04/2019 | Serial | 002 |
| Patient Name | Mrs. GINA JHA | Contact No | 9875348837 |
| Address | 100 R B SARANI | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||