Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01948 | Date 22/04/2019 |
| Token No | SM/18-19/4945 22/07/2019 | Serial | 038 |
| Patient Name | Miss SUMAN SINGH | Contact No | 7003282065 |
| Address | 1 DEY GHAT LANE | Age | 18 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||