Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05477 | Date 28/02/2022 |
| Token No | SM/21-22/2279 28/02/2022 | Serial | 004 |
| Patient Name | Miss ANU BHARTI | Contact No | 6290305660 |
| Address | 63 DHULIPARA | Age | 9 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||