Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13671 | Date 29/10/2025 |
| Token No | SM/25-26/2430 29/10/2025 | Serial | 019 |
| Patient Name | Mr. RAJNIKANT KUMAR SAHANI | Contact No | 9939735258 |
| Address | 99 THAKURBATI STREET | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||