Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05200 | Date 03/01/2022 |
| Token No | SM/21-22/1751 03/01/2022 | Serial | 007 |
| Patient Name | Mr. AJAY KUMAR JAISWARA | Contact No | 8582904901 |
| Address | 7 DEY GHAT LANE | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||