Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02882 | Date 22/08/2019 |
| Token No | SM/18-19/5854 22/08/2019 | Serial | 032 |
| Patient Name | Mrs. SONAM SINGH | Contact No | 7003485575 |
| Address | 2 NO BECHU DEY LANE | Age | 26 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||