Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 10965 | Date 18/12/2023 |
| Token No | SM/22-23/13861 18/12/2023 | Serial | 012 |
| Patient Name | Mr. SAI KUMAR | Contact No | 9038896131 |
| Address | 72/54 KHATIR BAZAR LANE | Age | 25 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||