Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02238 | Date 11/06/2019 |
| Token No | SM/22-23/14320 17/01/2024 | Serial | 040 |
| Patient Name | Mr. MAHADEV MODAK | Contact No | 9051376165 |
| Address | DOSTI LANE | Age | 73 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||