Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03868 | Date 04/03/2020 |
| Token No | SM/19-20/8638 04/03/2020 | Serial | 014 |
| Patient Name | Mr. BALU PARIYALI | Contact No | 9748923835 |
| Address | 19 DOSTI LANE | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||