Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01453 | Date 20/12/2018 |
| Token No | SM/18-19/2070 20/12/2018 | Serial | 018 |
| Patient Name | Mrs. ANU SINGH | Contact No | 7003485575 |
| Address | 2 NO BECHU DEY LANE | Age | 25 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||