Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02107 | Date 24/05/2019 |
| Token No | SM/18-19/3782 24/05/2019 | Serial | 005 |
| Patient Name | Mr. CHHOTU JAISWARA | Contact No | 8229989443 |
| Address | 13 DEY GHAT LANE | Age | 28 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||