Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05170 | Date 20/12/2021 |
| Token No | SM/21-22/1669 20/12/2021 | Serial | 003 |
| Patient Name | Mr. RAM BABU | Contact No | 8961366563 |
| Address | DEY STREET | Age | 27 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||