Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08050 | Date 28/12/2022 |
| Token No | SM/22-23/7227 28/12/2022 | Serial | 024 |
| Patient Name | Mr. DIPAK SHA | Contact No | 7621998438 |
| Address | RAM SITA LANE | Age | 30 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||