Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 04571 | Date 07/07/2021 |
| Token No | SM/22-23/4530 16/08/2022 | Serial | 005 |
| Patient Name | Mrs. ARATI DALAL | Contact No | 9339622493 |
| Address | NILMONI GHOSH LANE, MAHESH | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||