Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06825 | Date 27/08/2022 |
| Token No | SM/22-23/4727 27/08/2022 | Serial | 002 |
| Patient Name | Miss AROHI SHA | Contact No | NOT GIVEN |
| Address | RAMSITA LANE | Age | 10 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||