Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05543 | Date 16/03/2022 |
| Token No | SM/21-22/2437 16/03/2022 | Serial | 002 |
| Patient Name | Mrs. LABONI SRIMANI | Contact No | 8697724520 |
| Address | 25/A DEY STREET | Age | 28 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||