Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03478 | Date 26/11/2019 |
| Token No | SM/19-20/7673 26/11/2019 | Serial | 002 |
| Patient Name | Miss RIYA SINGH | Contact No | 9088655501 |
| Address | RAM SITA LINE, INDIA JUTE MILL | Age | 13 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||