Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05097 | Date 25/11/2021 |
| Token No | SM/21-22/1494 25/11/2021 | Serial | 004 |
| Patient Name | Master CHOTU KUMAR | Contact No | 9875567737 |
| Address | 7 DEY GHAT LANE | Age | 4 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||