Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00573 | Date 18/12/2019 |
| Token No | SM/19-20/1173 18/12/2019 | Serial | 009 |
| Patient Name | Mrs. URMILA GIRI | Contact No | 9065824868 |
| Address | 190 NEW MAHESH PRABASHNAGAR 712203 | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||