Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10162 | Date 28/08/2023 |
| Token No | SM/22-23/12012 28/08/2023 | Serial | 014 |
| Patient Name | Mr. AJAY KUMAR | Contact No | 7827386215 |
| Address | RAM SITA LANE | Age | 39 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||