Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08101 | Date 04/01/2023 |
| Token No | SM/22-23/7338 04/01/2023 | Serial | 001 |
| Patient Name | Mr. CHHOTE LAL ROY | Contact No | 9135564554 |
| Address | RAM SITA LANE | Age | 33 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||