Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 00266 | Date 27/09/2019 |
| Token No | SM/19-20/368 27/09/2019 | Serial | 021 |
| Patient Name | Mrs. PUNAM SINGH | Contact No | 8777087723 |
| Address | 1138 S K NAGAR RISHRA M 712249 | Age | 43 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||