Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03115 | Date 24/09/2019 |
| Token No | SM/18-19/7058 21/10/2019 | Serial | 025 |
| Patient Name | Miss BABITA SINGH | Contact No | 7890711134 |
| Address | DEY STREET | Age | 9 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||