Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 13512 | Date 12/09/2025 |
| Token No | SM/25-26/2022 12/09/2025 | Serial | 008 |
| Patient Name | Mr. PRITAM BAIRAGI | Contact No | 7003315964 |
| Address | 1/B/3 RAILAND CIRCULAR ROAD | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||