Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02385 | Date 01/07/2019 |
| Token No | SM/22-23/14330 18/01/2024 | Serial | 002 |
| Patient Name | Mr. MANTU ROY | Contact No | NOT GIVEN |
| Address | RUDRA RAM PANDIT LANE | Age | 18 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||