Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01271 | Date 01/11/2018 |
| Token No | SM/18-19/1747 01/11/2018 | Serial | 024 |
| Patient Name | Miss URMILA KUMARI | Contact No | 8820834468 |
| Address | DEYSTREET | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||