Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13740 | Date 17/11/2025 |
| Token No | SM/25-26/2659 17/11/2025 | Serial | 023 |
| Patient Name | Master ASISH PRASAD | Contact No | 8981623432 |
| Address | 112 R.B. SARANI | Age | 5 months Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||