Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 00740 | Date 17/01/2020 |
| Token No | SM/19-20/2407 18/02/2020 | Serial | 043 |
| Patient Name | Mr. GANESH SINGH | Contact No | 6290186340 |
| Address | 704 S K NAGAR PRABASHNAGAR RISHRA M 712249 | Age | 24 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||