Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13322 | Date 30/07/2025 |
| Token No | SM/25-26/1463 30/07/2025 | Serial | 003 |
| Patient Name | Mr. DINESH MAJHI | Contact No | 8420976222 |
| Address | 10 RAM SITA LANE | Age | 35 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||