Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05267 | Date 10/01/2022 |
| Token No | SM/21-22/1849 10/01/2022 | Serial | 013 |
| Patient Name | Mr. SANTOSH SHA | Contact No | 7980936744 |
| Address | 6 RAM SITA LANE | Age | 43 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||