Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02304 | Date 18/06/2019 |
| Token No | SM/18-19/4265 18/06/2019 | Serial | 019 |
| Patient Name | Mr. AMIT VERMA | Contact No | 9598203221 |
| Address | 79 DEY ST | Age | 36 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||