Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01314 | Date 29/11/2018 |
| Token No | SM/25-26/2132 20/09/2025 | Serial | 006 |
| Patient Name | Mr. RAJDEV SINGH | Contact No | 6291618593 |
| Address | 1 NO DEY GHAT LANE | Age | 53 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||