Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02071 | Date 16/05/2019 |
| Token No | SM/18-19/3684 16/05/2019 | Serial | 024 |
| Patient Name | Mrs. NISHA DEVI | Contact No | 6289255472 |
| Address | 104 R.B. SARANI | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||