Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03129 | Date 26/09/2019 |
| Token No | SM/18-19/6817 01/10/2019 | Serial | 007 |
| Patient Name | Mr. AMARJEET JAISWARA | Contact No | 9038500624 |
| Address | 10 DEY STREET | Age | 38 Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||