Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03390 | Date 15/11/2019 |
| Token No | SM/18-19/7426 15/11/2019 | Serial | 025 |
| Patient Name | Mr. MANSINGH JAISWARA | Contact No | 8777582299 |
| Address | 13 DEY GHAT LANE | Age | 20 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||