Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13404 | Date 19/08/2025 |
| Token No | SM/25-26/1719 19/08/2025 | Serial | 003 |
| Patient Name | Mr. RAJKUMAR GUPTA | Contact No | 6291652238 |
| Address | 136 G.T. ROAD MANIKTALA, DEY | Age | 55 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||