Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03037 | Date 13/09/2019 |
| Token No | SM/18-19/6406 13/09/2019 | Serial | 010 |
| Patient Name | Master RAHUL KUMAR | Contact No | 9073607023 |
| Address | RAM SITA LINE | Age | 10 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||