Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04744 | Date 17/08/2021 |
| Token No | SM/21-22/860 17/08/2021 | Serial | 003 |
| Patient Name | Mrs. SRUTI PRASAD | Contact No | 6289789956 |
| Address | 45/A PANCHANAN TALA | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||