Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03666 | Date 03/01/2020 |
| Token No | SM/19-20/8219 03/01/2020 | Serial | 017 |
| Patient Name | Miss ANITA RAJBHAR | Contact No | 9839784595 |
| Address | 13 DOSTI LANE | Age | 3 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||