Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01760 | Date 07/03/2019 |
| Token No | SM/18-19/2708 07/03/2019 | Serial | 020 |
| Patient Name | Mrs. KUSUM DEVI | Contact No | NOT GIVEN |
| Address | 10 DEY ST | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||