Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01572 | Date 15/01/2019 |
| Token No | SM/18-19/2272 15/01/2019 | Serial | 003 |
| Patient Name | Mrs. LAXMI BISWAL | Contact No | 8444872666 |
| Address | 10 DEY STREET | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||