Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04214 | Date 31/03/2021 |
| Token No | SM/20-21/9234 31/03/2021 | Serial | 006 |
| Patient Name | Miss AYUSHI KUMARI | Contact No | NOT GIVEN |
| Address | 104 INDIA JUTE MILL | Age | 6 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||