Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04800 | Date 26/08/2021 |
| Token No | SM/21-22/943 26/08/2021 | Serial | 008 |
| Patient Name | Mr. BISHAL SINGH | Contact No | NOT GIVEN |
| Address | 70 AKHRA BATI | Age | 13 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||