Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01040 | Date 04/10/2018 |
| Token No | SM/22-23/12022 28/08/2023 | Serial | 024 |
| Patient Name | Mrs. MINA KAHAR | Contact No | NOT GIVEN |
| Address | PAL BAGAN | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||