Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09562 | Date 14/07/2025 |
| Token No | SM/25-26/6606 20/08/2025 | Serial | 015 |
| Patient Name | Mr. SHIVAM UPADHYAY | Contact No | 9123736693 |
| Address | 2 A B ROAD RISHRA 712248 | Age | 21 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||