Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00653 | Date 04/09/2018 |
| Token No | SM/18-19/3575 10/05/2019 | Serial | 001 |
| Patient Name | Mr. PAWAN BHARTI | Contact No | 7044759374 |
| Address | 1 DEY GHAT LANE | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||