Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 06257 | Date 30/06/2022 |
| Token No | SM/22-23/3695 30/06/2022 | Serial | 004 |
| Patient Name | Mrs. SANDHYA GOMES | Contact No | 8981133872 |
| Address | 177 N N COLONY | Age | 53 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||