Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05100 | Date 25/11/2021 |
| Token No | SM/21-22/1498 25/11/2021 | Serial | 008 |
| Patient Name | Mr. SUNNY KUMAR RAM | Contact No | 7980068137 |
| Address | 7 DEY GHAT LANE | Age | 18 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||