Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03028 | Date 12/09/2019 |
| Token No | SM/18-19/6566 19/09/2019 | Serial | 026 |
| Patient Name | Mr. JAWAHAR LAL HELA | Contact No | NOT GIVEN |
| Address | 566 RAM SITA LANE | Age | 73 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||