Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07074 | Date 17/09/2022 |
| Token No | SM/22-23/5179 17/09/2022 | Serial | 004 |
| Patient Name | Mrs. MOLI SENSHARMA | Contact No | 7008968587 |
| Address | JOLKOL OFFICE STAFF | Age | 42 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||