Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03632 | Date 16/12/2019 |
| Token No | SM/19-20/8111 16/12/2019 | Serial | 042 |
| Patient Name | Mr. KAMLESH PATEL | Contact No | 9330203774 |
| Address | 3 DEY GHAT LANE | Age | 33 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||