Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05353 | Date 28/01/2022 |
| Token No | SM/21-22/2017 28/01/2022 | Serial | 001 |
| Patient Name | Mr. BHIM SINGH | Contact No | NOT GIVEN |
| Address | PATUA PARA V.I.P GOLI | Age | 71 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||