Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 02560 | Date 20/07/2019 |
| Token No | SM/18-19/5010 20/07/2019 | Serial | 020 |
| Patient Name | Mrs. KRISHNA PATHAK | Contact No | 9638528978 |
| Address | MANIKTALA | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||