Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13178 | Date 30/06/2025 |
| Token No | SM/25-26/1016 30/06/2025 | Serial | 001 |
| Patient Name | Mr. MANAGER SHAH | Contact No | 7070833552 |
| Address | 80/A/2 DEY STREET | Age | 63 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||