Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06809 | Date 24/08/2022 |
| Token No | SM/22-23/4677 24/08/2022 | Serial | 005 |
| Patient Name | Miss ANITA KUMARI | Contact No | NOT GIVEN |
| Address | 53 DEY STREET | Age | 25 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||