Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03347 | Date 11/11/2019 |
| Token No | SM/18-19/7323 11/11/2019 | Serial | 007 |
| Patient Name | Mrs. URMILA DEVI | Contact No | NOT GIVEN |
| Address | 4 dey ghat lane | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||