Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09093 | Date 17/05/2023 |
| Token No | SM/22-23/9638 17/05/2023 | Serial | 032 |
| Patient Name | Mr. LAKSHMAN SHAW | Contact No | NOT GIVEN |
| Address | 10 DOSTI LANE | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||