Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05268 | Date 10/01/2022 |
| Token No | SM/25-26/2747 24/11/2025 | Serial | 034 |
| Patient Name | Mr. SANTOSH SAH.... | Contact No | 7980936744 |
| Address | 6 RAM SITA LANE | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||