Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04423 | Date 01/06/2021 |
| Token No | SM/21-22/321 01/06/2021 | Serial | 010 |
| Patient Name | Mrs. SATHI KURI | Contact No | 8017536603 |
| Address | 105 RAJYADHARPUR GOV. COLONY | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||