Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03359 | Date 14/11/2019 |
| Token No | SM/18-19/7359 14/11/2019 | Serial | 007 |
| Patient Name | Mrs. URMILA NATH | Contact No | 8420022499 |
| Address | 10 DOSTI LANE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||