Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03288 | Date 24/10/2019 |
| Token No | SM/22-23/14745 12/02/2024 | Serial | 021 |
| Patient Name | Miss KAJAL KHATIK | Contact No | 8585876464 |
| Address | 79 DEY STREET | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||