Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06784 | Date 22/08/2022 |
| Token No | SM/22-23/4620 22/08/2022 | Serial | 008 |
| Patient Name | Mrs. APPALA GUMRI | Contact No | NOT GIVEN |
| Address | 12 PITAMBAR DEY LANE | Age | 55 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||