Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03052 | Date 16/09/2019 |
| Token No | SM/18-19/6461 16/09/2019 | Serial | 021 |
| Patient Name | Mr. RUPESH KUMAR | Contact No | 9038969541 |
| Address | COCKRAIN ROAD | Age | 16 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||