Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06096 | Date 14/06/2022 |
| Token No | SM/22-23/3401 14/06/2022 | Serial | 021 |
| Patient Name | Mrs. KAMLI PRADHAN | Contact No | NOT GIVEN |
| Address | 14 DEY GHAT LANE | Age | 39 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||