Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03292 | Date 24/10/2019 |
| Token No | SM/18-19/7162 24/10/2019 | Serial | 022 |
| Patient Name | Mrs. KAJAL NATH | Contact No | 8240001865 |
| Address | 42 G T ROAD | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||