Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04587 | Date 13/07/2021 |
| Token No | SM/22-23/6488 21/11/2022 | Serial | 028 |
| Patient Name | Mr. CHHOTE LAL RAM | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 31 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||