Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02923 | Date 28/08/2019 |
| Token No | SM/18-19/5991 28/08/2019 | Serial | 011 |
| Patient Name | Mrs. REKHA BHAGAT | Contact No | 8581073230 |
| Address | CHATRA | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||