Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05922 | Date 24/05/2022 |
| Token No | SM/22-23/3087 24/05/2022 | Serial | 026 |
| Patient Name | Mrs. MANJU BALIAL | Contact No | NOT GIVEN |
| Address | 33 B.L.C.M BYE LANE | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||