Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01791 | Date 13/03/2019 |
| Token No | SM/18-19/2812 13/03/2019 | Serial | 002 |
| Patient Name | Mrs. AMRITA PRASAD | Contact No | 7003608069 |
| Address | 3 dey ghat lane | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||