Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13554 | Date 20/09/2025 |
| Token No | SM/25-26/2142 20/09/2025 | Serial | 016 |
| Patient Name | Mr. SHIV SHANKAR MISHRA | Contact No | 9883110292 |
| Address | 113 R.B. SARANI | Age | 73 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||