Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06731 | Date 16/08/2022 |
| Token No | SM/22-23/4526 16/08/2022 | Serial | 001 |
| Patient Name | Mrs. FULPARI MAJHI | Contact No | 9007825193 |
| Address | 26 BOSE PARA | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||