Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02307 | Date 18/06/2019 |
| Token No | SM/19-20/8866 26/08/2020 | Serial | 006 |
| Patient Name | Mrs. GAYETRI SINGH | Contact No | NOT GIVEN |
| Address | 1 DEY GHAT LANE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||