Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05011 | Date 28/10/2021 |
| Token No | SM/22-23/5567 17/10/2022 | Serial | 021 |
| Patient Name | Mr. RAJU PRASAD | Contact No | 9883670314 |
| Address | 3 DEY GHAT LANE | Age | 35 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||