Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00582 | Date 19/12/2019 |
| Token No | SM/25-26/2036 14/05/2025 | Serial | 083 |
| Patient Name | Mr. TINKU SHAW | Contact No | 9088586388 |
| Address | VAGORITI LANE MAHESH 712202 | Age | 41 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||