Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03601 | Date 12/12/2019 |
| Token No | SM/19-20/8020 12/12/2019 | Serial | 008 |
| Patient Name | Miss JYOTI KUMARI | Contact No | 6291830312 |
| Address | 18 DHARMATALA LANE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||