Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00621 | Date 01/09/2018 |
| Token No | SM/18-19/2469 14/02/2019 | Serial | 035 |
| Patient Name | Miss MITHU BARAL | Contact No | 9088392735 |
| Address | PANCHANAN TALA LANE | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||