Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03376 | Date 14/11/2019 |
| Token No | SM/19-20/8473 24/01/2020 | Serial | 015 |
| Patient Name | Mrs. SRIMATI SINGH | Contact No | 9874442831 |
| Address | 75 DEY STREET | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||