Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05327 | Date 20/01/2022 |
| Token No | SM/21-22/1950 20/01/2022 | Serial | 004 |
| Patient Name | Miss MANISHA KUMARI | Contact No | 8100018829 |
| Address | 126 R.B. SARANI | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||