Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10622 | Date 03/10/2023 |
| Token No | SM/25-26/1976 10/09/2025 | Serial | 003 |
| Patient Name | Mr. SHYAM BABU SHA | Contact No | NOT GIVEN |
| Address | 79 DEY STREET | Age | 20 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||