Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03984 | Date 14/07/2020 |
| Token No | SM/19-20/8804 14/07/2020 | Serial | 002 |
| Patient Name | Miss URMILA KUMARI | Contact No | 6289953443 |
| Address | 79 DEY STREET | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||