Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06092 | Date 14/06/2022 |
| Token No | SM/22-23/3392 14/06/2022 | Serial | 012 |
| Patient Name | Mrs. ANJU RAJBHAR | Contact No | NOT GIVEN |
| Address | 29/A BAZAR BYE LANE | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||