Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04729 | Date 16/08/2021 |
| Token No | SM/24-25/16504 27/05/2024 | Serial | 010 |
| Patient Name | Mrs. RENU DEVI BHARTI | Contact No | 7439047351 |
| Address | 63 DHULI PARA | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||