Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04879 | Date 07/09/2021 |
| Token No | SM/21-22/1074 07/09/2021 | Serial | 002 |
| Patient Name | Miss SUSHMA KUMARI | Contact No | 9088454993 |
| Address | NEW MAHESH | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||