Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04677 | Date 03/08/2021 |
| Token No | SM/24-25/20757 29/01/2025 | Serial | 016 |
| Patient Name | Mr. BIKASH JAISWARA.. | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 12 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||