Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06186 | Date 22/06/2022 |
| Token No | SM/22-23/3542 22/06/2022 | Serial | 005 |
| Patient Name | Mrs. RITA BARAT | Contact No | 9007896325 |
| Address | 9 NO LINE | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||