Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05773 | Date 02/05/2022 |
| Token No | SM/22-23/2879 05/05/2022 | Serial | 018 |
| Patient Name | Mrs. SONAM SHAW | Contact No | 9883200653 |
| Address | 52 PANCHANAN TALA LANE | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||