Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02712 | Date 03/08/2019 |
| Token No | SM/18-19/6229 05/09/2019 | Serial | 011 |
| Patient Name | Mrs. ANJU DEVI | Contact No | 7890275798 |
| Address | 79 DEY STREET | Age | 48 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||