Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 05690 | Date 18/04/2022 |
| Token No | SM/22-23/2695 18/04/2022 | Serial | 004 |
| Patient Name | Mrs. GITA SHAW | Contact No | 9831345622 |
| Address | PRAVASH NAGAR | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||