Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01195 | Date 16/03/2020 |
| Token No | SM/19-20/3136 16/03/2020 | Serial | 036 |
| Patient Name | Mrs. RASMONI SINGH | Contact No | |
| Address | 55/B GURU GARDEN ROAD PRABASHNAGAR 712203 | Age | 60 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||