Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10517 | Date 25/09/2023 |
| Token No | SM/22-23/12676 25/09/2023 | Serial | 037 |
| Patient Name | Mrs. BASANA SRIMANI | Contact No | 8974698729 |
| Address | 61 DEY STREET | Age | 75 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||