Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03118 | Date 25/09/2019 |
| Token No | SM/18-19/6685 25/09/2019 | Serial | 003 |
| Patient Name | Mrs. PRITI PATHAK | Contact No | 9681245705 |
| Address | INDIA JUTE MILL | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||