Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12522 | Date 11/01/2025 |
| Token No | SM/25-26/220 23/04/2025 | Serial | 031 |
| Patient Name | Master ISHAN KOIRI | Contact No | 9874089203 |
| Address | 36 PANCHANANTALA LANE | Age | 13 days Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||