Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04480 | Date 14/06/2021 |
| Token No | SM/21-22/412 14/06/2021 | Serial | 010 |
| Patient Name | Mrs. PUJA PASHI | Contact No | NOT GIVEN |
| Address | 55 ROY LAND ROAD | Age | 25 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||