Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07792 | Date 24/11/2022 |
| Token No | SM/22-23/6594 24/11/2022 | Serial | 008 |
| Patient Name | Miss SAYANI DHAR | Contact No | 8777024969 |
| Address | 62 DHULI PARA LANE | Age | 24 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||