Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02336 | Date 24/06/2019 |
| Token No | SM/18-19/4471 27/06/2019 | Serial | 004 |
| Patient Name | Mrs. FULMATI SHARMA | Contact No | 9239273043 |
| Address | 62A RAILAND ROAD | Age | 73 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||