Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03328 | Date 05/11/2019 |
| Token No | SM/18-19/7257 05/11/2019 | Serial | 009 |
| Patient Name | Miss PRIYANKA VERMA | Contact No | 9123644236 |
| Address | 82 DEY STREET | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||