Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00347 | Date 29/08/2018 |
| Token No | SM/18-19/1359 04/10/2018 | Serial | 018 |
| Patient Name | Mrs. MURALI DEVI | Contact No | NOT GIVEN |
| Address | 17/A/3 CHOWDHAURI PARA LANE | Age | 69 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 90/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||