Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10153 | Date 28/08/2023 |
| Token No | SM/22-23/11999 28/08/2023 | Serial | 001 |
| Patient Name | Mr. PABAN SINGH | Contact No | 078282065 |
| Address | 1NO DEY GHAT LANE | Age | 25 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||