Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05736 | Date 21/04/2022 |
| Token No | SM/22-23/2780 21/04/2022 | Serial | 004 |
| Patient Name | Mrs. RINA JAISWARA.... | Contact No | 7003385435 |
| Address | 4 DEY GHAT LANE | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||