Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04996 | Date 27/10/2021 |
| Token No | SM/24-25/18725 10/09/2024 | Serial | 004 |
| Patient Name | Miss NIRMALA SINGH | Contact No | NOT GIVEN |
| Address | 14C DEY STREET | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||