Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03296 | Date 25/10/2019 |
| Token No | SM/18-19/7172 25/10/2019 | Serial | 008 |
| Patient Name | Miss PRIYANKA KUMARI SHA | Contact No | 9883205494 |
| Address | 6 RAM SITA LANE | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||