Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05565 | Date 21/03/2022 |
| Token No | SM/21-22/2477 21/03/2022 | Serial | 012 |
| Patient Name | Mr. SUMIT JAISWARA | Contact No | 7439124867 |
| Address | 7 DEY GHAT LANE | Age | 18 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||