Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05444 | Date 17/02/2022 |
| Token No | SM/21-22/2186 17/02/2022 | Serial | 011 |
| Patient Name | Mrs. PRIYA AGRAHARI | Contact No | 6291839121 |
| Address | 82 DEY STREET | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||