Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06447 | Date 22/07/2022 |
| Token No | SM/22-23/3981 22/07/2022 | Serial | 020 |
| Patient Name | Mrs. KEHEKASA | Contact No | 8604629044 |
| Address | 27 TIN BAZAR BYE LANE | Age | 26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||