Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02323 | Date 20/06/2019 |
| Token No | SM/18-19/4324 20/06/2019 | Serial | 010 |
| Patient Name | Miss NISHA KUMARI | Contact No | 8013111755 |
| Address | 79 DEY STREET | Age | 17 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||