Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06703 | Date 10/08/2022 |
| Token No | SM/22-23/4455 10/08/2022 | Serial | 040 |
| Patient Name | Mrs. KARINA TANTI | Contact No | 7044849149 |
| Address | 4 COOLIE PARA, BANDEL | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||