Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04014 | Date 24/08/2020 |
| Token No | SM/19-20/8850 24/08/2020 | Serial | 009 |
| Patient Name | Mrs. RITA YADAV | Contact No | NOT GIVEN |
| Address | DHARMATALA | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||