Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02770 | Date 08/08/2019 |
| Token No | SM/18-19/5530 08/08/2019 | Serial | 017 |
| Patient Name | Mrs. GOPA SINHA | Contact No | 9874670868 |
| Address | 134/1 THAKUR BATI STREET | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||