Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07739 | Date 21/11/2022 |
| Token No | SM/22-23/6471 21/11/2022 | Serial | 011 |
| Patient Name | Miss DHARITRI PARIYALI | Contact No | 8479051690 |
| Address | 5 DOSTI LANE | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||