Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01992 | Date 26/04/2019 |
| Token No | SM/18-19/3425 26/04/2019 | Serial | 021 |
| Patient Name | Mr. RATAN KR PATWA | Contact No | 9038696522 |
| Address | RAM SITA LANE | Age | 27 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||