Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02906 | Date 27/08/2019 |
| Token No | SM/18-19/5944 27/08/2019 | Serial | 024 |
| Patient Name | Miss G KHUSI | Contact No | NOT GIVEN |
| Address | 106 R B SARANI | Age | 13 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||