Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03110 | Date 24/09/2019 |
| Token No | SM/18-19/6652 24/09/2019 | Serial | 007 |
| Patient Name | Mrs. NANDINI PRASAD | Contact No | 8910277257 |
| Address | 3 DEY GHAT LANE | Age | 25 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||