Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02001 | Date 30/04/2019 |
| Token No | SM/22-23/3974 22/07/2022 | Serial | 013 |
| Patient Name | Mr. HARINDAR RAM | Contact No | NOT GIVEN |
| Address | 7 DEY GHAT LANE | Age | 30 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||