Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13786 | Date 27/11/2025 |
| Token No | SM/25-26/2789 27/11/2025 | Serial | 005 |
| Patient Name | Mr. SACHIN BISWAL | Contact No | 7439031904 |
| Address | 10 K D B LANE | Age | 18 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||