Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04043 | Date 24/09/2020 |
| Token No | SM/19-20/8915 24/09/2020 | Serial | 008 |
| Patient Name | Mrs. MUNNI DEBI | Contact No | 7033189156 |
| Address | 12 RAM SITA LANE | Age | 25 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||