Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04005 | Date 14/08/2020 |
| Token No | SM/22-23/6950 13/12/2022 | Serial | 006 |
| Patient Name | Mrs. TUMPA SHAW | Contact No | 8981218370 |
| Address | 573 G T ROAD, MANIKTALA | Age | 37 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||