Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05010 | Date 28/10/2021 |
| Token No | SM/21-22/1324 28/10/2021 | Serial | 001 |
| Patient Name | Miss PRIYANKSHI SINGH | Contact No | 9740852531 |
| Address | 1 DEY GHAT LANE | Age | 10 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||