Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08683 | Date 31/03/2023 |
| Token No | SM/22-23/8662 31/03/2023 | Serial | 012 |
| Patient Name | Mr. SHAMBHU SHAW | Contact No | 9903524805 |
| Address | RAM SITA LANE | Age | 39 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||