Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04931 | Date 27/09/2021 |
| Token No | SM/21-22/1169 27/09/2021 | Serial | 006 |
| Patient Name | Mr. ASUTOSH PANDEY | Contact No | 8334073908 |
| Address | 4 DEY GHAT LANE | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||