Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13475 | Date 06/09/2025 |
| Token No | SM/25-26/1913 06/09/2025 | Serial | 001 |
| Patient Name | Mr. SIBAM KUMAR | Contact No | 9711716321 |
| Address | RAM SITA LANE | Age | 15 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||