Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05231 | Date 05/01/2022 |
| Token No | SM/21-22/1798 05/01/2022 | Serial | 013 |
| Patient Name | Mr. SIKANDAR GUPTA | Contact No | 8100352992 |
| Address | 14D DEY STREET | Age | 12 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||