Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03633 | Date 16/12/2019 |
| Token No | SM/19-20/8114 16/12/2019 | Serial | 045 |
| Patient Name | Miss NANDINI MISHRA | Contact No | 9163175531 |
| Address | 76 DEY STREET | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||