Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04680 | Date 04/08/2021 |
| Token No | SM/21-22/766 04/08/2021 | Serial | 005 |
| Patient Name | Miss KHUSI KUMARI | Contact No | 7439021685 |
| Address | 6 RAM SITA LANE | Age | 9 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||