Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02084 | Date 17/05/2019 |
| Token No | SM/18-19/3717 17/05/2019 | Serial | 021 |
| Patient Name | Baby AYUSH SINGH | Contact No | 6291481185 |
| Address | 3 DEY GHAT LANE | Age | 4 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||