Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13270 | Date 23/07/2025 |
| Token No | SM/25-26/1329 23/07/2025 | Serial | 002 |
| Patient Name | Mr. CHHOTE LAL ROY. | Contact No | 8420812655 |
| Address | RAM SITA LANE | Age | 38 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||