Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03457 | Date 21/11/2019 |
| Token No | SM/18-19/7624 21/11/2019 | Serial | 045 |
| Patient Name | Miss SANDHYA PRASAD | Contact No | 7278628863 |
| Address | PAL BAGAN, 10 DEY STREET | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||