Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02951 | Date 30/08/2019 |
| Token No | SM/18-19/6079 30/08/2019 | Serial | 062 |
| Patient Name | Mrs. RUKMINI BHAGAT | Contact No | 8479918131 |
| Address | AKHRA BATI LANE | Age | 55 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||