Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 04618 | Date 15/07/2021 |
| Token No | SM/21-22/642 15/07/2021 | Serial | 016 |
| Patient Name | Miss NIDHI SINGH | Contact No | NOT GIVEN |
| Address | 2 BAZAR BYE LANE | Age | 7 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||