Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12631 | Date 07/02/2025 |
| Token No | SM/24-25/20868 07/02/2025 | Serial | 004 |
| Patient Name | Mr. KAPIL SHA. | Contact No | 8583947200 |
| Address | RAM SITA LANE | Age | 54 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||