Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 12168 | Date 30/09/2024 |
| Token No | SM/24-25/19145 01/10/2024 | Serial | 011 |
| Patient Name | Mrs. G. MALA | Contact No | 8981913487 |
| Address | 23/56 B.P.2ND LANE | Age | 62 Y Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||