Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04812 | Date 26/08/2021 |
| Token No | SM/21-22/1552 02/12/2021 | Serial | 006 |
| Patient Name | Mrs. SHEFALI BAIRAGI | Contact No | 9748609480 |
| Address | DHULI PARA | Age | 73 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||