Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13414 | Date 26/08/2025 |
| Token No | SM/25-26/1746 26/08/2025 | Serial | 013 |
| Patient Name | Mr. RAJIB CHAUDHARY | Contact No | 7980543850 |
| Address | 62A RAILAND ROAD | Age | 18 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||