Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03046 | Date 16/09/2019 |
| Token No | SM/18-19/6445 16/09/2019 | Serial | 005 |
| Patient Name | Baby ARVI SINGH | Contact No | 7003282065 |
| Address | 1 DEY GHAT LANE | Age | 6 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||