Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13665 | Date 25/10/2025 |
| Token No | SM/25-26/2403 25/10/2025 | Serial | 025 |
| Patient Name | Mr. GAUTAM KUMAR DUBEY | Contact No | 9931700710 |
| Address | 3 WILLIUM CAREY ROAD | Age | 28 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||