Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04018 | Date 26/08/2020 |
| Token No | SM/22-23/3066 24/05/2022 | Serial | 005 |
| Patient Name | Mr. PANKAJ KUMAR SINGH | Contact No | 6291618593 |
| Address | 1 DEY GHAT LANE | Age | 15 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||