Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13606 | Date 13/10/2025 |
| Token No | SM/25-26/2270 13/10/2025 | Serial | 006 |
| Patient Name | Mr. RAM UJAGAR SHAW. | Contact No | 9903873822 |
| Address | 10 DEY STREET | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||