Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03185 | Date 15/10/2019 |
| Token No | SM/22-23/9269 28/04/2023 | Serial | 031 |
| Patient Name | Miss AMISHA KUMARI | Contact No | 8479971460 |
| Address | 9 RAM SITA LANE | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||