Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13267 | Date 22/07/2025 |
| Token No | SM/25-26/1322 22/07/2025 | Serial | 007 |
| Patient Name | Mr. RAM BABU KUMAR SHA | Contact No | 8961366563 |
| Address | DEY STREET | Age | 26 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||