Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 05750 | Date 22/04/2022 |
| Token No | SM/22-23/2796 22/04/2022 | Serial | 002 |
| Patient Name | Mrs. SANGITA SHAW | Contact No | NOT GIVEN |
| Address | PRABASH NAGAR | Age | 45 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||