Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04681 | Date 04/08/2021 |
| Token No | SM/22-23/13611 07/12/2023 | Serial | 014 |
| Patient Name | Mr. GOPAL NATH | Contact No | 9073591132 |
| Address | 8 DOSTI LANE | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||