Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04796 | Date 26/08/2021 |
| Token No | SM/21-22/939 26/08/2021 | Serial | 004 |
| Patient Name | Mrs. SANGITA SINGH | Contact No | NOT GIVEN |
| Address | 70 AKHRA BATI | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||