Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05564 | Date 21/03/2022 |
| Token No | SM/21-22/2476 21/03/2022 | Serial | 011 |
| Patient Name | Mr. VISHAL KUMAR | Contact No | 8100947461 |
| Address | 13 SEY GHAT LANE | Age | 18 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||