Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 08063 | Date 29/12/2022 |
| Token No | SM/22-23/7256 29/12/2022 | Serial | 017 |
| Patient Name | Mr. GYANALAL SAHANI | Contact No | NOT GIVEN |
| Address | NEAR SAMSHANKALI | Age | 62 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||