Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10395 | Date 14/09/2023 |
| Token No | SM/22-23/12478 14/09/2023 | Serial | 018 |
| Patient Name | Mr. SARBESH PANDEY | Contact No | 8910494872 |
| Address | 12 DEY STREET | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||