Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13363 | Date 11/08/2025 |
| Token No | SM/25-26/1612 11/08/2025 | Serial | 005 |
| Patient Name | Mr. AJAY JAISWARA | Contact No | 8582904901 |
| Address | 7 DEY GHAT LANE | Age | 40 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||