Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02238 | Date 11/06/2019 |
| Token No | SM/18-19/4101 11/06/2019 | Serial | 032 |
| Patient Name | Mr. MAHADEV MODAK | Contact No | 9051376165 |
| Address | DOSTI LANE | Age | 73 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||