Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00912 | Date 10/02/2020 |
| Token No | SM/19-20/2135 10/02/2020 | Serial | 005 |
| Patient Name | Mrs. ASHA SINGH | Contact No | |
| Address | 440 S K NAGAR NAYABASTI PRABASHNAGAR 712249 | Age | 8 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||