Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03038 | Date 13/09/2019 |
| Token No | SM/18-19/6409 13/09/2019 | Serial | 013 |
| Patient Name | Mrs. DIMPLE TATI | Contact No | 8100824337 |
| Address | 82 DEY STREET | Age | 28 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||