Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05845 | Date 17/05/2022 |
| Token No | SM/22-23/2979 17/05/2022 | Serial | 005 |
| Patient Name | Mrs. RUPALI MODOK | Contact No | 9051244899 |
| Address | 506B G T ROAD | Age | 27 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||