Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00581 | Date 19/12/2019 |
| Token No | SM/19-20/1181 19/12/2019 | Serial | 005 |
| Patient Name | Mrs. SAROJ DEVI | Contact No | 9088586388 |
| Address | 43 VAGOROTI LANE MAHESH | Age | 28 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||