Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03427 | Date 19/11/2019 |
| Token No | SM/18-19/7510 19/11/2019 | Serial | 007 |
| Patient Name | Miss PUJA KUMARI | Contact No | 9088248711 |
| Address | 5 DOSTI LANE | Age | 16 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||