Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03357 | Date 11/11/2019 |
| Token No | SM/18-19/7351 11/11/2019 | Serial | 035 |
| Patient Name | Mrs. SUNITA RAJBHAR | Contact No | 8444904288 |
| Address | 5 DOSTI LANE | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||