Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05236 | Date 05/01/2022 |
| Token No | SM/21-22/1804 05/01/2022 | Serial | 019 |
| Patient Name | Mr. PANKAJ SINGH | Contact No | 6291859362 |
| Address | 1 DEY GHAT LANE | Age | 15 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||