Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04377 | Date 12/05/2021 |
| Token No | SM/21-22/249 12/05/2021 | Serial | 002 |
| Patient Name | Mr. PINTU SINGH | Contact No | 9748052531 |
| Address | 1/1 DEY GHAT LANE | Age | 37 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||