Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07092 | Date 20/09/2022 |
| Token No | SM/22-23/5214 20/09/2022 | Serial | 006 |
| Patient Name | Mr. HIRALAL SASMOL | Contact No | NOT GIVEN |
| Address | 40A BHAGIRATHI LANE | Age | 40 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||