Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02044 | Date 10/05/2019 |
| Token No | SM/18-19/3587 10/05/2019 | Serial | 013 |
| Patient Name | Mrs. LAXMI NATH | Contact No | 9051778054 |
| Address | 8/A DOSTI LANE | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||