Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03208 | Date 17/10/2019 |
| Token No | SM/21-22/601 13/07/2021 | Serial | 016 |
| Patient Name | Mrs. RINKU JAISWARA | Contact No | NOT GIVEN |
| Address | 7 DEY GHAT LANE | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||