Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07125 | Date 23/09/2022 |
| Token No | SM/22-23/5296 23/09/2022 | Serial | 018 |
| Patient Name | Mrs. LACHHMI BHAGAT | Contact No | NOT GIVEN |
| Address | 17 HOSPITAL LANE | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||