Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08922 | Date 28/04/2023 |
| Token No | SM/22-23/9261 28/04/2023 | Serial | 023 |
| Patient Name | Mr. CHUNILAL HELA | Contact No | 9088671993 |
| Address | 79 DEY STREET | Age | 54 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||