Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03291 | Date 24/10/2019 |
| Token No | SM/18-19/7161 24/10/2019 | Serial | 021 |
| Patient Name | Miss SIMA METE | Contact No | 6289809476 |
| Address | 11 NO A.B.GARDEN LANE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||