Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09690 | Date 19/07/2023 |
| Token No | SM/22-23/11028 19/07/2023 | Serial | 019 |
| Patient Name | Miss JYOTI RAM | Contact No | 9836696657 |
| Address | CHHOTO BELU | Age | 16 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||