Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03192 | Date 15/10/2019 |
| Token No | SM/18-19/6927 15/10/2019 | Serial | 019 |
| Patient Name | Mr. MALESWAR PADIARI | Contact No | 9748923835 |
| Address | 19 DOSTI LANE | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||