Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13713 | Date 07/11/2025 |
| Token No | SM/25-26/2543 07/11/2025 | Serial | 003 |
| Patient Name | Mr. ANAND RAM | Contact No | 8100586867 |
| Address | CHOTOBELUR | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||