Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02326 | Date 20/06/2019 |
| Token No | SM/18-19/4422 25/06/2019 | Serial | 010 |
| Patient Name | Mr. MAHADEB KOHAR | Contact No | 9123622530 |
| Address | 162 G.T. ROAD | Age | 76 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||