Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03590 | Date 09/12/2019 |
| Token No | SM/19-20/7974 09/12/2019 | Serial | 047 |
| Patient Name | Mrs. BHAGMATI TIWARI | Contact No | 9875688263 |
| Address | 77 DEY STREET | Age | 71 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||