Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04012 | Date 24/08/2020 |
| Token No | SM/19-20/8845 24/08/2020 | Serial | 004 |
| Patient Name | Mrs. ANITA RAI | Contact No | 6289671652 |
| Address | 23 BARAL BAGAN LANE | Age | 21 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||