Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 08792 | Date 21/04/2023 |
| Token No | SM/22-23/9008 21/04/2023 | Serial | 028 |
| Patient Name | Miss PRITI KUMARI | Contact No | NOT GIVEN |
| Address | 11 RAM SITA LANE | Age | 18 MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||