Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01799 | Date 13/03/2019 |
| Token No | SM/22-23/10326 19/06/2023 | Serial | 013 |
| Patient Name | Mr. SANJAY KUMAR KOIRI | Contact No | 8820981498 |
| Address | 79 DEY STREET | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||