Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02184 | Date 04/06/2019 |
| Token No | SM/18-19/7395 14/11/2019 | Serial | 043 |
| Patient Name | Miss ALKA SINGH | Contact No | 9874442831 |
| Address | 75 DEY ST | Age | 8 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||