Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09471 | Date 23/06/2023 |
| Token No | SM/22-23/15420 23/03/2024 | Serial | 012 |
| Patient Name | Mr. BIJOY SHAH | Contact No | 7044017319 |
| Address | 6 RAM SITA LANE | Age | 34 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||