Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04579 | Date 08/07/2021 |
| Token No | SM/22-23/9035 21/04/2023 | Serial | 055 |
| Patient Name | Miss UJALA KUMARI | Contact No | NOT GIVEN |
| Address | 79 DEY STREET | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||