Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01348 | Date 07/12/2018 |
| Token No | SM/22-23/14487 31/01/2024 | Serial | 006 |
| Patient Name | Mr. SANJAY APOT | Contact No | 8582884955 |
| Address | DEY STREET | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||