Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11464 | Date 02/05/2024 |
| Token No | SM/24-25/16029 02/05/2024 | Serial | 012 |
| Patient Name | Mr. SURAJ SHAH | Contact No | 9006014033 |
| Address | RAM SITA LANE | Age | 20 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||