Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12922 | Date 24/04/2025 |
| Token No | SM/25-26/239 24/04/2025 | Serial | 002 |
| Patient Name | Master PRINCE RAM | Contact No | 8334025470 |
| Address | 84 DEY STREET | Age | 11 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||