Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00257 | Date 24/08/2018 |
| Token No | SM/22-23/11110 21/07/2023 | Serial | 013 |
| Patient Name | Mrs. SIMA DEVI | Contact No | NOT GIVEN |
| Address | 8 DEY STREET | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||