Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04620 | Date 16/07/2021 |
| Token No | SM/21-22/645 16/07/2021 | Serial | 002 |
| Patient Name | Mr. HIRA SASHMAL | Contact No | 9903298513 |
| Address | 40/1 BHAGIRATHI LANE | Age | 39 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||