Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05357 | Date 28/01/2022 |
| Token No | SM/21-22/2022 28/01/2022 | Serial | 006 |
| Patient Name | Mr. CHHOTU JAISWARA.. | Contact No | 7003385435 |
| Address | 13 DEY GHAT LANE | Age | 35 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||