Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01984 | Date 21/06/2022 |
| Token No | SM/22-23/699 21/06/2022 | Serial | 047 |
| Patient Name | Mr. SANJAY KUMAR SINGH | Contact No | 8981806760 |
| Address | 1/A/12 JAYASHREE TEXTILES RISHRA PRABASHNAGAR 712249 | Age | 41 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||