Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05273 | Date 11/01/2022 |
| Token No | SM/21-22/1857 11/01/2022 | Serial | 004 |
| Patient Name | Mrs. G GITA | Contact No | 9330693158 |
| Address | 100 R B SARANI | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||