Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05388 | Date 03/02/2022 |
| Token No | SM/21-22/2091 03/02/2022 | Serial | 006 |
| Patient Name | Miss SAMPA BHARADWAJ | Contact No | 8420422529 |
| Address | 10 DEY STREET | Age | 26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||