Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04262 | Date 07/04/2021 |
| Token No | SM/21-22/50 07/04/2021 | Serial | 002 |
| Patient Name | Mrs. PRAMILA DEVI | Contact No | NOT GIVEN |
| Address | 104 RISHI BANKIM SARANI | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||