Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01452 | Date 20/12/2018 |
| Token No | SM/18-19/2187 03/01/2019 | Serial | 008 |
| Patient Name | Mrs. GEETA DEBI | Contact No | 8274941168 |
| Address | 19 DASTI LANE | Age | 33 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||