Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04490 | Date 14/06/2021 |
| Token No | SM/21-22/423 14/06/2021 | Serial | 021 |
| Patient Name | Mrs. PINKI PRASAD | Contact No | 9967801412 |
| Address | 212 R B SARANI | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||