Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05456 | Date 21/02/2022 |
| Token No | SM/21-22/2205 21/02/2022 | Serial | 009 |
| Patient Name | Mrs. RINA SHA | Contact No | 9875622779 |
| Address | 125/A MANIKTALA | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||