Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01949 | Date 22/04/2019 |
| Token No | SM/18-19/3313 22/04/2019 | Serial | 006 |
| Patient Name | Miss PRIYANSHI SINGH | Contact No | 9748052531 |
| Address | 1 DEY GHAT LANE | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||