Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04871 | Date 18/08/2023 |
| Token No | SM/25-26/4452 07/07/2025 | Serial | 047 |
| Patient Name | Mr. SIYARAM YADAV | Contact No | 7890676701 |
| Address | 95 NEW MAHESH SERAMPORE 712203 | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||