Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04582 | Date 09/07/2021 |
| Token No | SM/21-22/578 09/07/2021 | Serial | 002 |
| Patient Name | Mr. RAKESH KUMAR GUPTA | Contact No | 9831216401 |
| Address | TIN BAZAR, BAZAR BYE LANE | Age | 32 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||