Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02879 | Date 22/08/2019 |
| Token No | SM/18-19/5847 22/08/2019 | Serial | 025 |
| Patient Name | Mrs. RAJANI BISWAL | Contact No | 9836010315 |
| Address | COCKRAIN ROAD | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||