Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00522 | Date 09/12/2019 |
| Token No | SM/19-20/1020 09/12/2019 | Serial | 001 |
| Patient Name | Mr. AZAD SINGH | Contact No | 8583045541 |
| Address | PRABASHNAGAR HINDI SCHOOL | Age | 9 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||