Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 09962 | Date 14/08/2023 |
| Token No | SM/22-23/11607 14/08/2023 | Serial | 017 |
| Patient Name | Miss SUSHMA MODI | Contact No | 6291943962 |
| Address | 36 KHAS BAGAN | Age | 9 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||