Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 09153 | Date 23/05/2023 |
| Token No | SM/22-23/9762 23/05/2023 | Serial | 001 |
| Patient Name | Mr. SAMIR JAISWARA | Contact No | 7605837780 |
| Address | 7 DEY GHAT LANE | Age | 36 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||