Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02849 | Date 20/08/2019 |
| Token No | SM/18-19/5750 20/08/2019 | Serial | 018 |
| Patient Name | Mrs. SUNITA PRASAD | Contact No | 6291402454 |
| Address | 3 DEY GHAT LANE | Age | 37 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||