Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04513 | Date 21/06/2021 |
| Token No | SM/21-22/970 27/08/2021 | Serial | 006 |
| Patient Name | Mr. AMARNATH JOT | Contact No | 9163674195 |
| Address | 10 PALBAGAN | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||