Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03291 | Date 24/10/2019 |
| Token No | SM/22-23/6759 01/12/2022 | Serial | 013 |
| Patient Name | Miss SIMA METE | Contact No | 6289809476 |
| Address | 11 NO A.B.GARDEN LANE | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||