Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01306 | Date 27/11/2018 |
| Token No | SM/18-19/1828 27/11/2018 | Serial | 016 |
| Patient Name | Mrs. BASANA SRIMANI | Contact No | 9874698729 |
| Address | 61 DEY STREET | Age | 68 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||