Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05613 | Date 31/03/2022 |
| Token No | SM/21-22/2562 31/03/2022 | Serial | 017 |
| Patient Name | Mrs. RAKHI GOSWAMI | Contact No | 7603082978 |
| Address | 39 LAL BAHADUR SASTRI ROAD | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||