Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 07458 | Date 01/11/2022 |
| Token No | SM/25-26/2184 08/10/2025 | Serial | 003 |
| Patient Name | Mr. RAMYOG SHA | Contact No | NOT GIVEN |
| Address | 13 TIN BAZAR | Age | 67 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||