Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01564 | Date 11/01/2019 |
| Token No | SM/18-19/5089 24/07/2019 | Serial | 012 |
| Patient Name | Mrs. RUMA SIMLAI | Contact No | |
| Address | Age | 55 YRS Female | |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||