Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02716 | Date 05/08/2019 |
| Token No | SM/18-19/5402 05/08/2019 | Serial | 006 |
| Patient Name | Mrs. RESHMA DEVI | Contact No | 9433640537 |
| Address | 10 DOSTI LANE | Age | 70 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||