Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07020 | Date 12/09/2022 |
| Token No | SM/22-23/5063 12/09/2022 | Serial | 010 |
| Patient Name | Mr. MOHON ROY | Contact No | NOT GIVEN |
| Address | 8K RAM SITA LANE | Age | 60 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||