Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04649 | Date 23/07/2021 |
| Token No | SM/21-22/692 23/07/2021 | Serial | 002 |
| Patient Name | Mrs. MADHABI SINGH | Contact No | NOT GIVEN |
| Address | PACHU BAZAR | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||