Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06772 | Date 18/08/2022 |
| Token No | SM/22-23/4593 18/08/2022 | Serial | 003 |
| Patient Name | Mrs. SAMU PASWAN | Contact No | NOT GIVEN |
| Address | BOSE PARA, SITAL SARKAR LANE | Age | 60 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||