Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01295 | Date 27/03/2020 |
| Token No | SM/19-20/3456 27/03/2020 | Serial | 005 |
| Patient Name | Mrs. SHADHANA SHADUKA | Contact No | |
| Address | SANI PARA BY LANE | Age | 56 Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||