Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01856 | Date 02/04/2019 |
| Token No | SM/18-19/4176 14/06/2019 | Serial | 034 |
| Patient Name | Mrs. PUJA SINGH | Contact No | 9748052531 |
| Address | 1/1 DEY GHAT LANE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||