Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02276 | Date 14/06/2019 |
| Token No | SM/22-23/13811 15/12/2023 | Serial | 001 |
| Patient Name | Mrs. SARITA SINGH | Contact No | 7003800575 |
| Address | RAM SITA LANE | Age | 32 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||