Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04409 | Date 19/05/2021 |
| Token No | SM/21-22/301 19/05/2021 | Serial | 023 |
| Patient Name | Mrs. MAMTA THAKUR | Contact No | NOT GIVEN |
| Address | 3 PITAMBAR DEY LANE | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||