Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04397 | Date 19/05/2021 |
| Token No | SM/22-23/5129 15/09/2022 | Serial | 010 |
| Patient Name | Mr. GANI NATH SHAH | Contact No | NOT GIVEN |
| Address | 6/182 COCKRAIN ROAD | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||