Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00021 | Date 03/08/2018 |
| Token No | SM/18-19/5099 25/07/2019 | Serial | 004 |
| Patient Name | Mrs. RITA RANA. | Contact No | 9433211958 |
| Address | 5 NO RUDRA RAM PANDIT LANE | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||