Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04477 | Date 14/06/2021 |
| Token No | SM/21-22/409 14/06/2021 | Serial | 007 |
| Patient Name | Mrs. MAMATA THAKUR | Contact No | 9330401675 |
| Address | 3/A PITAMBAR DEY LANE | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||