Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00119 | Date 13/09/2019 |
| Token No | SM/19-20/129 13/09/2019 | Serial | 028 |
| Patient Name | Mr. GOUTAM SINGH | Contact No | 9007657782 |
| Address | 37/S JANNAGAR ROAD,PRABASHNAGAR | Age | 40 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||