Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07488 | Date 03/11/2022 |
| Token No | SM/22-23/5975 03/11/2022 | Serial | 003 |
| Patient Name | Mrs. ANITA POLAI | Contact No | 8961611285 |
| Address | 7/361 COCKRAIN ROAD | Age | 28 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||