Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12783 | Date 17/03/2025 |
| Token No | SM/25-26/1181 11/07/2025 | Serial | 014 |
| Patient Name | Master REHAN RAJBHAR | Contact No | 9123750538 |
| Address | 14B DEY STREET | Age | 10 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||