Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01450 | Date 20/12/2018 |
| Token No | SM/18-19/2064 20/12/2018 | Serial | 012 |
| Patient Name | Miss PRIYANSI SINGH | Contact No | |
| Address | DEY STREET GHAT | Age | 7 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||