Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00696 | Date 09/01/2020 |
| Token No | SM/19-20/1479 09/01/2020 | Serial | 008 |
| Patient Name | Mrs. SITAL BAULI | Contact No | |
| Address | PRABASHNAGAR ARIJAN QUARTER 712203 | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||