Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 06105 | Date 15/06/2022 |
| Token No | SM/22-23/3421 15/06/2022 | Serial | 015 |
| Patient Name | Mrs. ROSHNI AGARWAL | Contact No | NOT GIVEN |
| Address | BANGALAXMI BYE LANE | Age | 47 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||