Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04044 | Date 24/09/2020 |
| Token No | SM/19-20/8916 24/09/2020 | Serial | 009 |
| Patient Name | Mrs. NIVA KUMARI SAH | Contact No | 9748589532 |
| Address | 6 RAM SITA LANE | Age | 20 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||