Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06196 | Date 23/06/2022 |
| Token No | SM/22-23/5279 23/09/2022 | Serial | 001 |
| Patient Name | Master ROHIT RAI | Contact No | NOT GIVEN |
| Address | DEY ST | Age | 6 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||