Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05762 | Date 25/04/2022 |
| Token No | SM/22-23/2821 25/04/2022 | Serial | 019 |
| Patient Name | Mrs. KAJAL KUMARI | Contact No | 9748589544 |
| Address | 12 R B SARANI | Age | 15 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||