Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02249 | Date 13/06/2019 |
| Token No | SM/18-19/4129 13/06/2019 | Serial | 019 |
| Patient Name | Miss SOVA KUMARI PRASAD | Contact No | 9432444371 |
| Address | 52/A DEY ST | Age | 13 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||