Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01841 | Date 29/03/2019 |
| Token No | SM/18-19/5563 09/08/2019 | Serial | 012 |
| Patient Name | Mr. SUSHIL KUMAR DIWAN | Contact No | 9339672588 |
| Address | 99 R.B. SARANI | Age | 52 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||