Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02373 | Date 28/06/2019 |
| Token No | SM/18-19/4515 28/06/2019 | Serial | 005 |
| Patient Name | Mr. BALI RAM | Contact No | 9433382325 |
| Address | 3 NO DOSTI LANE | Age | 53 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||