Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05354 | Date 28/01/2022 |
| Token No | SM/21-22/2018 28/01/2022 | Serial | 002 |
| Patient Name | Mr. MAHENDRA YADAV | Contact No | 8274922657 |
| Address | RAM SITA LINE | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||