Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06465 | Date 25/07/2022 |
| Token No | SM/22-23/4026 25/07/2022 | Serial | 018 |
| Patient Name | Miss DISHA SHA | Contact No | 9330781332 |
| Address | 6/182 COCKRAIN ROAD | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||