Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01781 | Date 10/03/2019 |
| Token No | SM/21-22/2262 24/02/2022 | Serial | 010 |
| Patient Name | Mr. AJAY RAM | Contact No | NOT GIVEN |
| Address | 7 dey ghat lane | Age | 17 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||