Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01315 | Date 29/11/2018 |
| Token No | SM/21-22/1749 03/01/2022 | Serial | 005 |
| Patient Name | Mr. MUKESH SINGH | Contact No | 8335862752 |
| Address | 3 DEY GHAT LANE | Age | 44 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||