Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04740 | Date 16/08/2021 |
| Token No | SM/21-22/855 16/08/2021 | Serial | 019 |
| Patient Name | Miss GUNGUN BARAT | Contact No | NOT GIVEN |
| Address | R B SARANI | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||