Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04842 | Date 01/09/2021 |
| Token No | SM/21-22/1016 01/09/2021 | Serial | 002 |
| Patient Name | Miss RESHMI KUMARI | Contact No | NOT GIVEN |
| Address | 126 INDIA JUTE MILL 3 NO LINE | Age | 16 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||