Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 01241 | Date 31/10/2018 |
| Token No | SM/18-19/1701 31/10/2018 | Serial | 018 |
| Patient Name | Mrs. SIPRA DEY | Contact No | 9830714003 |
| Address | MAHESH COLONY | Age | 55 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||