Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04630 | Date 19/07/2021 |
| Token No | SM/22-23/7646 02/02/2023 | Serial | 015 |
| Patient Name | Mr. UJJAL METE | Contact No | 8274019861 |
| Address | 11 A B GARDEN LANE | Age | 18 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||