Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01762 | Date 07/03/2019 |
| Token No | SM/18-19/2716 07/03/2019 | Serial | 003 |
| Patient Name | Mrs. GITA DEVI | Contact No | 8274941168 |
| Address | 19 DOSTI LANE | Age | 38 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||