Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05509 | Date 08/03/2022 |
| Token No | SM/21-22/2354 08/03/2022 | Serial | 020 |
| Patient Name | Mr. ASUTOSH KOIRI | Contact No | 8481042290 |
| Address | 1 DEY STREET | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||