Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02506 | Date 19/07/2019 |
| Token No | SM/18-19/4867 19/07/2019 | Serial | 002 |
| Patient Name | Mrs. LILAWATI SINGH | Contact No | 9836124840 |
| Address | 76 DEY ST | Age | 62 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||