Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 10325 | Date 22/12/2025 |
| Token No | SM/25-26/12272 22/12/2025 | Serial | 032 |
| Patient Name | Mr. SURENDRA SINGH | Contact No | 9088686369 |
| Address | 0231 JAYASHREE TEXTILES DARAWAN LINE RISHRA PRAVASHNAGAR 712249 | Age | 63 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||