Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05574 | Date 23/03/2022 |
| Token No | SM/21-22/2503 23/03/2022 | Serial | 001 |
| Patient Name | Mr. UJJAL METE.. | Contact No | 8697302863 |
| Address | ANNADA BABU GARDEN LANE | Age | 16 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||