Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03458 | Date 21/11/2019 |
| Token No | SM/18-19/7625 21/11/2019 | Serial | 046 |
| Patient Name | Miss LAXMI JAISWARA | Contact No | NOT GIVEN |
| Address | 4 DEY GHAT LANE | Age | 9 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||