Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09816 | Date 01/08/2023 |
| Token No | SM/22-23/11275 01/08/2023 | Serial | 002 |
| Patient Name | Mr. PARSURAM SHAW | Contact No | 6289722464 |
| Address | RAM SITA LANE | Age | 53 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||