Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13379 | Date 14/08/2025 |
| Token No | SM/25-26/1673 14/08/2025 | Serial | 005 |
| Patient Name | Mr. PAWAN SINGH | Contact No | 9262969783 |
| Address | RAM SITA LANE | Age | 6 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||