Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 04438 | Date 03/06/2021 |
| Token No | SM/21-22/343 03/06/2021 | Serial | 003 |
| Patient Name | Mrs. PUTUL SHAW | Contact No | 9883854742 |
| Address | 31 BAZAR BYE LANE | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||