Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10051 | Date 21/08/2023 |
| Token No | SM/22-23/11795 21/08/2023 | Serial | 030 |
| Patient Name | Miss GUNJA KUMARI | Contact No | 9007737768 |
| Address | 5 DEY STREET | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||