Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01738 | Date 01/03/2019 |
| Token No | SM/18-19/6249 05/09/2019 | Serial | 031 |
| Patient Name | Mrs. MADHU GUPTA | Contact No | 9888889490 |
| Address | 12 DEY STREET | Age | 32 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||