Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04705 | Date 11/08/2021 |
| Token No | SM/21-22/808 11/08/2021 | Serial | 006 |
| Patient Name | Mrs. GITA DEWAN | Contact No | 9830293622 |
| Address | 8 A B GARDEN LANE | Age | 71 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||