Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04544 | Date 29/06/2021 |
| Token No | SM/21-22/2194 18/02/2022 | Serial | 008 |
| Patient Name | Mrs. PURNIMA GUPTA | Contact No | 8961772154 |
| Address | 100 R B SARANI | Age | 32 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||