Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04413 | Date 25/05/2021 |
| Token No | SM/21-22/306 25/05/2021 | Serial | 002 |
| Patient Name | Mrs. ASHA PATWA | Contact No | 6290614293 |
| Address | 106A/2 R B SARANI | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||