Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11045 | Date 17/01/2024 |
| Token No | SM/22-23/14319 17/01/2024 | Serial | 039 |
| Patient Name | Mr. MOHAN LAL SRIMANI | Contact No | 8697160243 |
| Address | 1 CHOWDHURY PARA LANE | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||