Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13323 | Date 30/07/2025 |
| Token No | SM/25-26/1465 30/07/2025 | Serial | 005 |
| Patient Name | Master ADITYA KOIRI | Contact No | 7003880804 |
| Address | 14B PAL BAGAN DEY STREET | Age | 8 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||