Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 08169 | Date 17/01/2023 |
| Token No | SM/22-23/7516 17/01/2023 | Serial | 021 |
| Patient Name | Miss ROSEMARY GOMES | Contact No | 8981133872 |
| Address | 177 N N COLONY | Age | 14 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||