Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04391 | Date 18/05/2021 |
| Token No | SM/22-23/7745 08/02/2023 | Serial | 002 |
| Patient Name | Mrs. NISHA GUPTA | Contact No | 6289715049 |
| Address | 14B DEY STREET | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||