Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02256 | Date 14/06/2019 |
| Token No | SM/18-19/4146 14/06/2019 | Serial | 004 |
| Patient Name | Mrs. RANI SINGH | Contact No | 6289487670 |
| Address | 23 BARAL BAGAN | Age | 20 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||