Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05320 | Date 19/01/2022 |
| Token No | SM/21-22/1941 19/01/2022 | Serial | 004 |
| Patient Name | Mr. DIPAK BHAGAT | Contact No | 8240218595 |
| Address | JOLKOL STAFF | Age | 27 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||