Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04519 | Date 23/06/2021 |
| Token No | SM/21-22/471 23/06/2021 | Serial | 001 |
| Patient Name | Mrs. PRITI PRASAD | Contact No | 8505803810 |
| Address | 45/A PANCHANAN TALA LANE | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||