Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01827 | Date 28/03/2019 |
| Token No | SM/18-19/2925 28/03/2019 | Serial | 005 |
| Patient Name | Mrs. ROJA PRADHAN | Contact No | |
| Address | 2 PANCHANAN TALA LANE | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||