Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03185 | Date 15/10/2019 |
| Token No | SM/18-19/6912 15/10/2019 | Serial | 004 |
| Patient Name | Miss AMISHA KUMARI | Contact No | 8479971460 |
| Address | 9 RAM SITA LANE | Age | 18 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||