Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05787 | Date 05/05/2022 |
| Token No | SM/22-23/2876 05/05/2022 | Serial | 015 |
| Patient Name | Mr. CHHOTU JAISWARA... | Contact No | 7003385435 |
| Address | 13 DEY GHAT LANE | Age | 30 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||