Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04709 | Date 11/08/2021 |
| Token No | SM/21-22/815 11/08/2021 | Serial | 013 |
| Patient Name | Mrs. MANISHA NATH | Contact No | 6290950935 |
| Address | 8 DOSTI LANE | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||