Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05955 | Date 27/05/2022 |
| Token No | SM/22-23/13409 29/11/2023 | Serial | 006 |
| Patient Name | Mrs. GITA SIL | Contact No | 8697062004 |
| Address | 213 G T ROAD | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||