Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02966 | Date 01/09/2019 |
| Token No | SM/18-19/6136 01/09/2019 | Serial | 028 |
| Patient Name | Miss MOHINI BISWAL | Contact No | 9330032624 |
| Address | COCKRAIN ROAD | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||