Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 08053 | Date 28/12/2022 |
| Token No | SM/25-26/2092 18/09/2025 | Serial | 015 |
| Patient Name | Mr. JEETENDRA DUBEY | Contact No | 8013552651 |
| Address | 12 WILLAM CAREY ROAD | Age | 58 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||