Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06700 | Date 10/08/2022 |
| Token No | SM/24-25/17916 05/08/2024 | Serial | 018 |
| Patient Name | Mrs. SIWANI KOSTA | Contact No | 8910059824 |
| Address | 451/F G T ROAD | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||