Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05828 | Date 12/05/2022 |
| Token No | SM/22-23/2948 12/05/2022 | Serial | 005 |
| Patient Name | Mr. AJIT KUMAR MAHATO | Contact No | 9062762283 |
| Address | 126 R B SARANI | Age | 15 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||