Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03602 | Date 12/12/2019 |
| Token No | SM/19-20/8021 12/12/2019 | Serial | 009 |
| Patient Name | Mrs. SHAMPATI KUWAR | Contact No | 8013111755 |
| Address | 79 DEY STREET | Age | 80 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||