Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00075 | Date 06/08/2018 |
| Token No | SM/18-19/739 21/08/2018 | Serial | 021 |
| Patient Name | Mrs. DUKHI BISWAL | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 61 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 170/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||