Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 12989 | Date 14/05/2025 |
| Token No | SM/25-26/449 14/05/2025 | Serial | 010 |
| Patient Name | Mrs. JERINA KHATOON | Contact No | 9674836175 |
| Address | SIMLA KALI TALA | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||