Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08875 | Date 26/04/2023 |
| Token No | SM/22-23/9183 26/04/2023 | Serial | 013 |
| Patient Name | Miss PRIYA PARIYALI | Contact No | 8777734946 |
| Address | 19 DOSTI LANE | Age | 13 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||