Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05607 | Date 31/03/2022 |
| Token No | SM/21-22/2556 31/03/2022 | Serial | 011 |
| Patient Name | Mrs. DIPIKA BHAGAT | Contact No | 6290946858 |
| Address | 11A AKHRA BATI LANE | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||