Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03528 | Date 02/12/2019 |
| Token No | SM/19-20/7812 02/12/2019 | Serial | 017 |
| Patient Name | Master OM KUMAR | Contact No | 9330399355 |
| Address | 6 RAM SITA LANE | Age | 5 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||