Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02512 | Date 13/12/2018 |
| Token No | SM/18-19/5195 13/12/2018 | Serial | 042 Last Visit: 13/12/2018 |
| Patient Name | Master TANU HARI | Contact No | |
| Address | MAHESH BANGALAXMI | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||