Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02534 | Date 22/07/2019 |
| Token No | SM/18-19/4934 22/07/2019 | Serial | 027 |
| Patient Name | Miss SUPRIYA BISWAL | Contact No | 9830606837 |
| Address | RAM SITA LANE | Age | 46 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||