Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04695 | Date 10/08/2021 |
| Token No | SM/21-22/792 10/08/2021 | Serial | 001 |
| Patient Name | Mr. PRASADI SHAW | Contact No | NOT GIVEN |
| Address | NEW MAHESH | Age | 76 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||