Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06706 | Date 11/08/2022 |
| Token No | SM/22-23/4470 11/08/2022 | Serial | 006 |
| Patient Name | Mrs. KEYA DEVI | Contact No | NOT GIVEN |
| Address | 10 HOSPITAL LANE | Age | 46 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||