Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09395 | Date 16/06/2023 |
| Token No | SM/22-23/10300 16/06/2023 | Serial | 036 |
| Patient Name | Mr. TILAK SHA | Contact No | 7008594520 |
| Address | 54/1 BHAGIRATHI LANE | Age | 54 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||