Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05230 | Date 05/01/2022 |
| Token No | SM/21-22/1797 05/01/2022 | Serial | 012 |
| Patient Name | Mr. SUNNY GUPTA | Contact No | NOT GIVEN |
| Address | 14D DEY STREET | Age | 14 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||