Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03245 | Date 21/10/2019 |
| Token No | SM/18-19/7059 21/10/2019 | Serial | 026 |
| Patient Name | Mrs. PINKI SINGH | Contact No | 7890711134 |
| Address | 17 DEY STREET | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||