Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00962 | Date 25/09/2018 |
| Token No | SM/22-23/6393 16/11/2022 | Serial | 023 |
| Patient Name | Mr. MISTRI LAL PRASAD | Contact No | 867588467 |
| Address | 3 DEY GHAT LANE | Age | 65 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||