Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05006 | Date 27/10/2021 |
| Token No | SM/22-23/4597 18/08/2022 | Serial | 007 |
| Patient Name | Mrs. PUJA PASWAN | Contact No | NOT GIVEN |
| Address | 17A SITAL SARKAR LANE | Age | 26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||