Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01129 | Date 11/10/2018 |
| Token No | SM/22-23/10828 12/07/2023 | Serial | 034 |
| Patient Name | Mrs. MAYA KOIRI | Contact No | 8481042209 |
| Address | DEY BARI, DEY STREET | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||