Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02993 | Date 05/09/2019 |
| Token No | SM/18-19/6246 05/09/2019 | Serial | 028 |
| Patient Name | Mrs. SANDHYA PANDEY | Contact No | 8910494872 |
| Address | 12 DEY STREET | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||