Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05430 | Date 16/02/2022 |
| Token No | SM/21-22/2159 16/02/2022 | Serial | 004 |
| Patient Name | Mrs. ANIMA SHAW | Contact No | 9163899748 |
| Address | 83 dey street | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||