Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04784 | Date 23/08/2021 |
| Token No | SM/21-22/914 23/08/2021 | Serial | 009 |
| Patient Name | Mr. CHHOTU JAISWARA | Contact No | 7003385435 |
| Address | 13 DEY GHAT LANE | Age | 29 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||