Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04493 | Date 14/06/2021 |
| Token No | SM/21-22/426 14/06/2021 | Serial | 024 |
| Patient Name | Mrs. DOLLY GUPTA | Contact No | 6291510296 |
| Address | N N COLONY | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||