Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 03261 | Date 26/11/2022 |
| Token No | SM/22-23/4764 26/11/2022 | Serial | 011 |
| Patient Name | Mr. JAYRAM SHAW | Contact No | 6290052808 |
| Address | QUATER NO 56 JAYASREE TEXT MILL RISHRA M PRABASHNAGAR 712249 | Age | 46 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||