Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04351 | Date 04/05/2021 |
| Token No | SM/21-22/316 01/06/2021 | Serial | 005 |
| Patient Name | Mrs. ARATI DEBI | Contact No | 7449792425 |
| Address | 12 R B SARANI | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||