Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04822 | Date 27/08/2021 |
| Token No | SM/22-23/8661 31/03/2023 | Serial | 011 |
| Patient Name | Mr. LAXMIKANT SHA | Contact No | 9748377028 |
| Address | 19 DOSTI LANE | Age | 38 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||