Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04483 | Date 14/06/2021 |
| Token No | SM/21-22/415 14/06/2021 | Serial | 013 |
| Patient Name | Mrs. RANI SINGH | Contact No | 6290642848 |
| Address | 15 BARAL BAGAN | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||