Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09950 | Date 11/08/2023 |
| Token No | SM/22-23/11577 11/08/2023 | Serial | 024 |
| Patient Name | Mr. SURAJ KUMAR SHA | Contact No | 9163721315 |
| Address | 6 RAM SITA LANE | Age | 7 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||