Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06701 | Date 10/08/2022 |
| Token No | SM/22-23/4453 10/08/2022 | Serial | 038 |
| Patient Name | Mrs. SIMRAN RAM | Contact No | 9836874491 |
| Address | 2 NO SHIBTALA LANE | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||