Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 07725 | Date 18/11/2022 |
| Token No | SM/24-25/17366 06/07/2024 | Serial | 004 |
| Patient Name | Miss SHRUTI GOMES | Contact No | 8981133872 |
| Address | 177 N.N. COLONY | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||