Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13182 | Date 30/06/2025 |
| Token No | SM/25-26/1027 30/06/2025 | Serial | 012 |
| Patient Name | Mr. SURENDAR PRASAD | Contact No | 8910125603 |
| Address | RUDRARAM PANDIT LANE | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||