Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04000 | Date 13/08/2020 |
| Token No | SM/19-20/8829 13/08/2020 | Serial | 004 |
| Patient Name | Mrs. ANKU KUMARI | Contact No | 9330017556 |
| Address | RAM SITA LINE | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||