Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05794 | Date 05/05/2022 |
| Token No | SM/22-23/2888 05/05/2022 | Serial | 027 |
| Patient Name | Mrs. LALITA DEVI... | Contact No | NOT GIVEN |
| Address | 12 NO LINE | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||