Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02180 | Date 04/06/2019 |
| Token No | SM/18-19/6156 03/09/2019 | Serial | 003 |
| Patient Name | Miss RASHMI KUMARI | Contact No | 8777584619 |
| Address | 11 DOSTI LANE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||