Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12879 | Date 10/04/2025 |
| Token No | SM/25-26/117 10/04/2025 | Serial | 008 |
| Patient Name | Mr. SAMENDAR KUMAR | Contact No | 8013280106 |
| Address | 180 QUATER, INDIA JUTE MILL | Age | 30 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||