Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04666 | Date 28/07/2021 |
| Token No | SM/24-25/18393 27/08/2024 | Serial | 010 |
| Patient Name | Mr. VIVEK JAISWARA.. | Contact No | 8621048977 |
| Address | 7 DEY GHAT LANE | Age | 17 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||