Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02430 | Date 08/07/2019 |
| Token No | SM/18-19/4653 08/07/2019 | Serial | 020 |
| Patient Name | Mrs. AMRITA PRASAD | Contact No | 9681051736 |
| Address | 3 DEY GHAT LANE | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||