Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08629 | Date 23/03/2023 |
| Token No | SM/22-23/8508 23/03/2023 | Serial | 019 |
| Patient Name | Mr. SANJAY SHA | Contact No | 9903865752 |
| Address | 11/291 RAM SITA LINE | Age | 40 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||