Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04765 | Date 18/08/2021 |
| Token No | SM/21-22/886 18/08/2021 | Serial | 002 |
| Patient Name | Mrs. RENU BHARTI | Contact No | 7890738007 |
| Address | DHULIPARA | Age | 27 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||