Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04655 | Date 26/07/2021 |
| Token No | SM/22-23/7806 10/02/2023 | Serial | 002 |
| Patient Name | Mr. DAYARAM YADAV | Contact No | 9903185321 |
| Address | 2 PANDIT RUDRARAM LANE | Age | 56 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||