Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00124 | Date 07/08/2018 |
| Token No | SM/18-19/758 01/09/2018 | Serial | 014 |
| Patient Name | Mr. SUNIL AGARWAL | Contact No | |
| Address | R B SARANI | Age | 48 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||