Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02773 | Date 08/08/2019 |
| Token No | SM/18-19/5534 08/08/2019 | Serial | 021 |
| Patient Name | Mrs. SAIL DEVI | Contact No | |
| Address | DASTI LANE | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||