Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04392 | Date 18/05/2021 |
| Token No | SM/22-23/12734 27/09/2023 | Serial | 004 |
| Patient Name | Mr. SHIVAM GUPTA | Contact No | 6289715049 |
| Address | 14B DEY STREET | Age | 18 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||