Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02792 | Date 13/08/2019 |
| Token No | SM/22-23/9081 24/04/2023 | Serial | 016 |
| Patient Name | Mrs. MOLI ADHIKARY | Contact No | 9636982200 |
| Address | MAHESH COLONY | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||