Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 13745 | Date 18/11/2025 |
| Token No | SM/25-26/2668 18/11/2025 | Serial | 007 |
| Patient Name | Mr. KRISHNA RAJBHAR | Contact No | 9062274270 |
| Address | 27/C TINBAZAR BYE LANE | Age | 42 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||