Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05638 | Date 04/04/2022 |
| Token No | SM/22-23/2605 04/04/2022 | Serial | 011 |
| Patient Name | Mrs. PUJA JOT | Contact No | 6291228794 |
| Address | 10 DOSTI LANE. PAL BAGAN | Age | 27 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||