Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13170 | Date 26/06/2025 |
| Token No | SM/25-26/986 26/06/2025 | Serial | 006 |
| Patient Name | Mr. TRIBENI JAISWAL | Contact No | 8651269011 |
| Address | 9 NO LINE RAM SITA LANE | Age | 44 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||