Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13772 | Date 24/11/2025 |
| Token No | SM/25-26/2739 24/11/2025 | Serial | 026 |
| Patient Name | Mr. H REMSANGPUIA | Contact No | 8436466297 |
| Address | 92B/1 DEY STREET | Age | 39 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||