Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04852 | Date 01/09/2021 |
| Token No | SM/21-22/1028 01/09/2021 | Serial | 014 |
| Patient Name | Mr. BALIRAM MAHATO | Contact No | 6291966678 |
| Address | 126 R B SARANI | Age | 21 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||