Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13013 | Date 22/05/2025 |
| Token No | SM/25-26/1201 14/07/2025 | Serial | 005 |
| Patient Name | Mr. AJAY KUMAR | Contact No | 6200824116 |
| Address | 12 PITAMBAR DEY LANE | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||