Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00075 | Date 06/08/2018 |
| Token No | SM/22-23/6992 15/12/2022 | Serial | 001 |
| Patient Name | Mrs. DUKHI BISWAL | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 61 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||