Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00649 | Date 04/09/2018 |
| Token No | SM/18-19/1770 16/11/2018 | Serial | 003 |
| Patient Name | Mrs. G. DEOKI | Contact No | 8697488028 |
| Address | 18, INDIAN JUTE MILL | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||