Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01567 | Date 11/01/2019 |
| Token No | SM/18-19/2258 11/01/2019 | Serial | 010 |
| Patient Name | Mrs. URMILA DEVI | Contact No | 9830706830 |
| Address | 120 MANIKTALA | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||