Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01365 | Date 13/12/2018 |
| Token No | SM/18-19/4905 19/07/2019 | Serial | 040 |
| Patient Name | Master YUVRAJ SINGH | Contact No | NOT GIVEN |
| Address | 6 RAM SITA LANE | Age | 4 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||