Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13250 | Date 18/07/2025 |
| Token No | SM/25-26/1277 18/07/2025 | Serial | 003 |
| Patient Name | Mr. RABI SINGH | Contact No | 9088376086 |
| Address | 70 AKHRABATI LANE | Age | 48 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||