Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10526 | Date 26/09/2023 |
| Token No | SM/22-23/12687 26/09/2023 | Serial | 003 |
| Patient Name | Mr. MOHIT RAM | Contact No | 9330385093 |
| Address | 4 DEY GHAT LANE | Age | 12 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||