Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04891 | Date 07/09/2021 |
| Token No | SM/21-22/1093 07/09/2021 | Serial | 021 |
| Patient Name | Mr. RABI VERMA | Contact No | NOT GIVEN |
| Address | RISHRA | Age | 34 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||