Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09344 | Date 14/06/2023 |
| Token No | SM/22-23/10193 14/06/2023 | Serial | 015 |
| Patient Name | Mr. MONMOHAN PANDEY | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 71 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||