Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02599 | Date 24/07/2019 |
| Token No | SM/18-19/5093 24/07/2019 | Serial | 016 |
| Patient Name | Miss TITLI SINHA | Contact No | 9830743198 |
| Address | 134/1 THAKUR BATI STREET | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||