Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06135 | Date 17/06/2022 |
| Token No | SM/22-23/3512 21/06/2022 | Serial | 005 |
| Patient Name | Mrs. RITU KUMARI PASWAN | Contact No | 7044143270 |
| Address | 26 BOSE PARA LANE | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||