Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05082 | Date 24/11/2021 |
| Token No | SM/21-22/2158 16/02/2022 | Serial | 003 |
| Patient Name | Mrs. SHREYA NATH | Contact No | 6291424322 |
| Address | 185/19 N N COLONY | Age | 17 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||