Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09403 | Date 19/06/2023 |
| Token No | SM/22-23/10322 19/06/2023 | Serial | 009 |
| Patient Name | Mr. MOHON PARIYALI | Contact No | 7003286371 |
| Address | 19 DOSTI LANE | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||