Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13715 | Date 10/11/2025 |
| Token No | SM/25-26/2550 10/11/2025 | Serial | 002 |
| Patient Name | Mr. RAJ KISHORE MAJHI | Contact No | 9433382325 |
| Address | 6 NO LINE, RAM SITA LANE | Age | 45 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||