Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03434 | Date 19/11/2019 |
| Token No | SM/22-23/5060 12/09/2022 | Serial | 007 |
| Patient Name | Mrs. BIMLA JAISWARA | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||