Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04964 | Date 04/10/2021 |
| Token No | SM/21-22/1229 04/10/2021 | Serial | 004 |
| Patient Name | Mr. BALIRAM SINGH | Contact No | 9330168636 |
| Address | DEY BARI | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||