Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03086 | Date 21/09/2019 |
| Token No | SM/18-19/6680 24/09/2019 | Serial | 035 |
| Patient Name | Mrs. MUMTAZ BIBI | Contact No | NOT GIVEN |
| Address | 40 DEY STREET | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||