Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03429 | Date 19/11/2019 |
| Token No | SM/18-19/7513 19/11/2019 | Serial | 010 |
| Patient Name | Mrs. SRIKUMARI RAJBHAR | Contact No | 9123750538 |
| Address | DEY STREET | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||