Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02885 | Date 26/08/2019 |
| Token No | SM/18-19/5876 26/08/2019 | Serial | 004 |
| Patient Name | Miss BANDANA BISWAL | Contact No | 9330032624 |
| Address | COCKRAIN ROAD | Age | 14 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||