Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05681 | Date 07/04/2022 |
| Token No | SM/22-23/2676 07/04/2022 | Serial | 005 |
| Patient Name | Mr. DHYANCHAND JAISWARA | Contact No | 8100947461 |
| Address | 13 DEY GHAT LANE | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||