Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06251 | Date 29/06/2022 |
| Token No | SM/22-23/3685 29/06/2022 | Serial | 013 |
| Patient Name | Mr. GANESH DHARA | Contact No | NOT GIVEN |
| Address | 45 AKHRA BATI LANE | Age | 84 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||