Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05247 | Date 07/01/2022 |
| Token No | SM/21-22/1823 07/01/2022 | Serial | 004 |
| Patient Name | Miss LAXMI JAISWARA | Contact No | 7103385435 |
| Address | 13 DEY GHAT LANE | Age | 13 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||