Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 09941 | Date 11/09/2025 |
| Token No | SM/25-26/7865 11/09/2025 | Serial | 072 |
| Patient Name | Mr. SHIVLAL DUBEY | Contact No | 9123890570 |
| Address | JAYASHREE TEXTILES RISHRA M 712249 | Age | 32 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||