Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 08833 | Date 24/04/2023 |
| Token No | SM/22-23/9095 24/04/2023 | Serial | 030 |
| Patient Name | Mrs. DHARAMSHILA SHAW | Contact No | 8910936678 |
| Address | LBS ROAD | Age | 32 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||