Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 00117 | Date 07/08/2018 |
| Token No | SM/22-23/4192 29/07/2022 | Serial | 021 |
| Patient Name | Miss PUSPA SHAW | Contact No | NOT GIVEN |
| Address | R B SARANI | Age | 26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||