Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13783 | Date 26/11/2025 |
| Token No | SM/25-26/2783 26/11/2025 | Serial | 023 |
| Patient Name | Mr. TARAK KOIRI | Contact No | 9433329294 |
| Address | 14/B DR. K D B LANE | Age | 49 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||