Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 03135 | Date 27/09/2019 |
| Token No | SM/18-19/6767 27/09/2019 | Serial | 041 |
| Patient Name | Master SANSKAR KUMAR | Contact No | NOT GIVEN |
| Address | 103 R.B.SARANI | Age | 4 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||