Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04440 | Date 03/06/2021 |
| Token No | SM/24-25/20120 10/12/2024 | Serial | 006 |
| Patient Name | Mrs. DIPALI RAJBHAR | Contact No | NOT GIVEN |
| Address | 10 DEY STREET | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||