Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02235 | Date 11/06/2019 |
| Token No | SM/21-22/2077 02/02/2022 | Serial | 003 |
| Patient Name | Mrs. MAMTA RAM | Contact No | 8420496341 |
| Address | 7 DEY GHAT LANE | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||