Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11839 | Date 23/07/2024 |
| Token No | SM/24-25/17696 23/07/2024 | Serial | 010 |
| Patient Name | Mrs. MAMATA GOMES | Contact No | 9330860525 |
| Address | DEY STREET | Age | 28YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||