Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05693 | Date 21/11/2023 |
| Token No | SM/22-23/15651 21/11/2023 | Serial | 022 |
| Patient Name | Mr. SAFIK ANSARI | Contact No | 8240905031 |
| Address | 26/A MIYAJAN DARJEE LANE 712203 | Age | 29 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||