Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00674 | Date 11/09/2018 |
| Token No | SM/18-19/908 11/09/2018 | Serial | 039 |
| Patient Name | Mrs. MOUBANI SIMLAI | Contact No | 9674323488 |
| Address | 166/A/1 THAKUR BATI STREET | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||